|Table of Contents|

Analysis of clinicopathological features,treatment and prognosis of breast medullary carcinoma

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 15
Page:
2767-2776
Research Field:
Publishing date:

Info

Title:
Analysis of clinicopathological features,treatment and prognosis of breast medullary carcinoma
Author(s):
TAN Qiao1; 2; SU Xiaohan1; 2; HOU Lingmi1; 2; LI Junyan3
1.Department of Breast and Thyroid Surgery,Biological Targeting Laboratory of Breast Cancer,Academician(expert) Work Station,Affiliated Hospital of North Sichuan Medical College,Sichuan Nanchong 637000,China;2.Sichuan Key Laboratory of Medical Imaging,Sichuan Nanchong 637000,China;3.Chengdu Fifth People's Hospital,Sichuan Chengdu 610000,China.
Keywords:
breast cancer; medullary carcinoma; invasive ductal carcinoma; prognosis; SEER
PACS:
R737.9
DOI:
10.3969/j.issn.1672-4992.2024.15.012
Abstract:
Objective:To investigate and compare the clinicopathologic features,treatment and prognosis between medullary breast carcinoma(MBC) and invasive ductal carcinoma(IDC).Methods:The data of patients with MBC and IDC diagnosed in SEER database and real-world multicenter(including:Three hospitals in Sichuan Province) from 2000 to 2018 were analyzed retrospectively,the clinical and pathological features,treatment and prognosis were compared and analyzed.Results:Compared with IDC patients,MBC patients had younger onset age,larger tumor diameter,higher histological grade,more triple negative type,later TNM stage and better prognosis.The univariate Cox regression analysis showed,the age of onset,histological grade,tumor size,T stage,N stage,M stage,TNM stage,surgical treatment or not,operation mode,radiotherapy and chemotherapy were correlated with OS.Age of onset,race,tumor size,T stage,N stage,M stage,TNM stage,surgical treatment or not,operation mode and radiotherapy were correlated with BSCC.Multivariate Cox model correction showed that age of onset,T stage,N stage,M stage,tumor size,surgery and chemotherapy were independent prognostic factors for OS and BCSS.The 10-year OS and 10-year BCSS of MBC patients were 83.0% and 91.8%,respectively,which were significantly different with IDC(P<0.001).The results of PSM analysis showed that the OS and BCSS of MBC patients were better than those of IDC patients in both SEER data and real-world multicenter clinical data.Conclusion:MBC is more invasive than IDC,but the prognosis of MBC is better than that of IDC.SEER data analysis showed that the prognosis of MBC is still better than that of IDC,and the difference was statistically significant.The reason for the better prognosis is the unique pathological type and standardized diagnosis and treatment of MBC,so we should pay more attention to the standardized diagnosis and treatment.

References:

［1］JOHNSON RH,ANDERSCK,LITTON JK,et al.Breast cancer in adolescents and young adults［J］.Pediatr Blood Cancer,2018,65(12):e27397.
［2］BRAY F,LAVERSANNE M,SUNG H,et al.Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries［J］.CA Cancer J Clin,2024,74(3):229-263.
［3］REZAIANZADEH A,SEPANDI M,AKRAMI M,et al.Pathological profile of patients with breast diseases in Shiraz［J］.Asian Pac Cancer Prev,2014,15(19):8191-8195.
［4］AKSOY A,ODABAS H,KAYA S,et al.Hormone receptor status and survival of medullary breast cancer patients.A Turkish cohort［J］.Saudi Med J，2017,38(2):156-162.
［5］MREMI A,GNANAMUTTUPULLE M,NTUNDU SH,et al.Invasive breast carcinoma of no special type with medullary pattern:A case report at a tertiary facility in Tanzania［J］.Clin Case Rep，2023，11(8):e7844.
［6］ROMANIUK A，LYNDIN M，SIKORA V，et al.Histological and immunohistochemical features of medullary breast cancer［J］.Fol Med Cracov，2015，52:41-48.
［7］YANG WT,BU H.Updates in the 5(th) edition of WHO classification of tumours of the breast［J］.Chinese Journal of Pathology,2020,49(5):400-405.
［8］GOLDHIRSH A,WINER EP,COATES AS,et al.Personalizing the treatment of women with early breast cancer:Highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013［J］.Ann Oncol,2013,24(9):2206-2223.
［9］BUDZIK MP,SOBIERAJ MT,SOBOL M,et al.Medullary breast cancer is a predominantly triple-negative breast cancer-histopathological analysis and comparison with invasive ductal breast cancer［J］.Arch Med Sci,2019,18(2):432-439.
［10］CHEN Y,XU Z,CHEN Y,et al.Comparison of the prognosis of medullary breast carcinoma and invasive ductal carcinoma:A SEER-based study［J］.Transl Cancer Res,2024,13(1):231-248.
［11］ANDERSON WF,CHU KC,CHANG S,et al.Comparison of age-specific incidence rate patterns for different histopathologic types of breast carcinoma［J］.Cancer Epidemiol Biomarkers Prev,2004,13:1128-1135.
［12］PARK I,KIM J,KIM M,et al.Comparison of the characteristics of medullary breast carcinoma and invasive ductal carcinoma［J］.Breast Cancer,2013,16:417-425.
［13］VO T,XING Y,MERIC-BERNSTAM F,et al.Long-term outcomes in patients with mucinous,medullary,tubular,and invasive ductal carcinomas after lumpectomy［J］.Am J Surg,2007,194(4):527-531.
［14］CAO AY,HE M,HUANG L,et al.Clinicopathologic characteristics at diagnosis and the survival of patients with medullary breast carcinoma in China_ a comparison with infiltrating ductal carcinoma-not otherwise specified［J］.World J Surg Oncol,2013,11:91.
［15］FLUCKE U,FLUCKE MT,HOY L,et al.Distinguishing medullary carcinoma of the breast from high-grade hormone receptor-negative invasive ductal carcinoma:An immunohistochemical approach［J］.Histopathology,2010,56(7):852-859.
［16］YANG WT，BU H.Updates in the 5(th) edition of WHO classification of tumours of the breast［J］.Chinese Journal of Pathology,2020,49(5):400-405.
［17］DE LA CRUZ KU G,KARAMCHANDANI M,CHAMDERGO-MICHILOT D,et al.Does breast-conserving surgery with radiotherapy have a better survival than mastectomy?A Meta-analysis of more than 1,500,000 patients［J］.Ann Surg Oncol,2022,29:6163-6188.
［18］REINFUSS M,STELMACH A,MITUS J,et al.Typical medullary carcinoma of the breast:A clinical and pathological analysis of 52 cases［J］.J Surg Oncol,1995,60:89-94.
［19］PEDERSEN L,ZEDELER K,HOLCK S,et al.Medullary carcinoma of the breast:Prevalence and prognostic importance of classical risk factorsin breast cancer［J］.Eur J Cancer,1995,31:2289-2295.
［20］WANG DY,FU XL,PAN GL,et al.A study of the relationship between breast cancer tissue type and prognosis［J］.Clinical Oncology,1985,12:135.
［21］THURMAN SA,SCHNITT SJ,CONNOLLY JL,et al.Outcom e after breast-conserving therapy for patients with stageⅠor Ⅱ mucinous,medullary,ortubular breast carcinoma［J］.Int J Radiat Oncol Biol Phys,2004,59:152-159.
［22］BASEN-ENGQUIST KM,RABER M,CARMACK CL,et al.Feasibility and efficacy of a weight gain prevention intervention for breast cancer patients receiving neoadjuvant chemotherapy:A randomized controlled pilot study［J］.Support Care Cancer,2020,28(12):5821-5832.
［23］AIHARA T,KUMAMARU H,ISHITOBI M,et al.Prognosis and effectiveness of chemotherapy for medullary breast carcinoma［J］.Breast Cancer Res Treat,2022,196(3):635-645.
［24］CHEN H,PU S,WANG L,et al.A risk stratification model to predict chemotherapy benefit in medullary carcinoma of the breast:A population-based SEER database［J］.Sci Rep,2023,13(1):10704.
［25］MATKOVIC B,JURETIC A,SEPAROVIC V,et al.Immunohistochemical analysis of ER,PR,HER-2,CK 5/6,p63 and EGFR antigen expression in medullary breast cancer［J］.Tumori,2008,94(6):838-844.
［26］MARTINEZ SR,BEAL SH,CANTER RJ,et al.Medullary carcinoma of the breast:A population-based perspective［J］.Med Oncol,2011,28(3):738-744.
［27］THOMAS A,REIS-FILHO JS,GEYER CE,et al.Rare subtypes of triple negative breast cancer:Current understanding and future directions［J］.NPJ Breast Cancer,2023,9(1):55.
［28］AKIN Y,UGURLU MU,KAYA H,et al.Diagnostic value of diffusion-weighted imaging and apparent diffusion coefficient values in the differentiation of breast lesions,histpathologic subgroups and correlation with prognostic factors using 3.0 Tesla MR［J］.J Breast Health,2016,12(3):123-132.
［29］AKBULUT M,ZEKIOGLU O,KAPKAC M,et al.Fine needle aspiration cytologic features of medullary carcinoma of the breast:A study of 20 cases with histologic correlation［J］.Acta Cytol,2009,53(2):165-173.
［30］NETRA SM,VANI BR,MURTHY VS.Cytomorphological study of medullary carcinoma of breast in comparison to infiltrating ductal carcinoma［J］.J Cytol,2018,35(4):195-198.
［31］ROMSNIUK A,LFNDIN M,SIKORA V,et al.Histological and immunohistochemical features of medullary breast cancer［J］.Folia Med Cracov,2015,55:41-48.
［32］LYNDIN M,HYRIAVENKO N,SIKORA V,et al.Invasive breast carcinoma of no special type with medullary pattern:Morphological and immunohistochemical features［J］.Turk-Patoloji-Derg,2022,38(3):205-212.
［33］LEE M,JARA-LAZARO AR,CHEOK PY,et al.Medullary breast carcinoma:A pathogenic review and immunohistochemical study using tissue microarray［J］.Singapore Med J,2022,63(7):394-401.

Memo

Memo:
四川省自然科学基金面上项目（编号：2022NSFSC0775）
Last Update: 2024-06-28