Outcome of special types of luminal breast cancer
Outcome of special types of luminal breast cancer
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DOI：
10.1093/annonc/mdr461
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发表时间：
2012-06-01
影响因子：
50.5
通讯作者：
Viale, G.
中科院分区：
文献类型：
--
作者：
Colleoni, M.;Rotmensz, N.;Viale, G.
背景：特殊类型乳腺癌的识别可能对评估预后和预测治疗反应有价值。方法：1997年至2005年在欧洲肿瘤研究所连续手术的7372例经免疫组织化学定义的腔内浸润性乳腺癌患者。然后我们根据组织学类型探讨复发模式。中位随访时间为5.8年。结果：5707例患者的肿瘤分类为浸润性导管癌（IDC, no），小叶癌851例，导管与小叶混合癌338例，筛状癌250例，黏液癌143例，管状癌83例。与IDC NOS相比，筛网状肿瘤患者的无病生存期（DFS）明显更长[5年DFS为97.9%比87.4%；风险比(HR) = 0.48；合并筛状合并管状癌（5年DFS为98.7% vs . 87.4%; HR = 0.45; P = 0.005）。与IDC相比，黏液性肿瘤的DFS相似（5年DFS 93% vs 87.4%; HR = 1.03; P = 0.91）。相反，小叶癌患者的DFS较差（5年DFS为86.8%比87.4%;HR = 1.27; P = 0.01）。结论：小管癌、筛状癌和小叶癌的诊断具有不同的预后意义。这些特殊类型的识别在腔内乳腺癌中具有重要的效用，在治疗算法中应予以考虑。
Background: The identification of special types of breast cancer might be of value in assessing prognosis and predicting response to therapy.Methods: A total of 7372 consecutive patients with immunohistochemically defined luminal invasive breast cancer operated at the European Institute of Oncology between 1997 and 2005 were included. We then explored patterns of recurrence by histological type. Median follow-up was 5.8 years.Results: Tumors from 5707 patients were classified as invasive ductal cancer (IDC) not otherwise specified (NOS), 851 lobular, 338 mixed ductal and lobular, 250 cribriform, 143 mucinous and 83 tubular carcinomas. Compared with IDC NOS disease-free survival (DFS) was significantly longer in patients with cribriform tumors [5-year DFS 97.9% versus 87.4%; hazard ratio (HR) = 0.48; P = 0.015) and in pooled cribriform plus tubular carcinomas (5-year DFS 98.7% versus 87.4%; HR = 0.45; P = 0.005). Mucinous tumors presented similar DFS if compared with IDC (5-year DFS 93 % versus 87.4%; HR = 1.03; P = 0.91). Conversely, DFS was poorer for patients with lobular carcinoma (5-year DFS 86.8% versus 87.4%; HR = 1.27; P = 0.01).Conclusions: The diagnosis of tubular, cribriform and lobular carcinomas carry distinct prognostic implications. The identification of these special types has a significant utility in luminal breast cancer and should be considered in therapeutic algorithms.