Inflammatory breast carcinoma and noninflammatory locally advanced breast carcinoma: Distinct clinicopathologic entities?
Inflammatory breast carcinoma and noninflammatory locally advanced breast carcinoma: Distinct clinicopathologic entities?
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DOI：
10.1200/jco.2003.07.082
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发表时间：
2003-06-15
影响因子：
45.3
通讯作者：
Chang, S
中科院分区：
文献类型：
--
作者：
Anderson, WF;Chu, KC;Chang, S
目的：炎症性乳腺癌(IBC)和非炎症性局部晚期乳腺癌(LABC)都与预后不良有关，但它们是否为不同的临床病理实体仍存在争议。材料和方法：为了确定IBC和LABC是否不同，我们在监测、流行病学和最终结果计划中比较了肿瘤特征、预后和特定年龄的发病率模式。结果：诊断时年龄较小、肿瘤分级较差、雌激素受体(ER)阴性的IBC(n=2,237)比LABC(n=7,985)更能预测IBC。IBC患者的乳腺癌生存率比LARC患者差(LOG-RANK检验，P<；.0001)。IBC的年龄别发病率在50岁前增加，然后趋于平缓，而LABC的发病率在所有年龄段都有所增加。当LABC的发生率按雌激素受体阳性(ERP)和阴性(ERN)的表达分层时，ERP和ERN的比率不同，即ERP的比率随着年龄的增加而增加，而ERN的比率在50岁后趋于平缓。当IBC的发生率按ER表达分层时，ERP和ERN的发生率在50岁后趋于平缓。结论：IBC和LABC似乎是不同的生物学实体，不同的预后因素谱和年龄特定的发病率模式表明IBC和LABC是不同的生物学实体。在50年前增加然后稳定的比率，可能表明绝经前暴露对维持IBC比率的影响比LABC更大。
Purpose: Inflammatory breast carcinoma (IBC) and noninflammatory locally advanced breast carcinoma (LABC) are both associated with poor prognosis; however, whether they are distinct clinicopathologic entities remains controversial.Materials and Methods: To determine whether IBC and LABC were different, we compared tumor characteristics, prognosis, and age-specific incidence rate patterns in the Surveillance, Epidemiology, and End-Results program. An age of 50 years served as a surrogate marker for menopause.Results: Younger age at diagnosis, poorer tumor grade, and negative estrogen receptors (ERs) were more predictive of IBC (n = 2,237) than of LABC in = 7,985). Breast carcinoma survival was worse for patients with IBC than for those with LARC (log-rank test, P < .0001). Age-specific incidence rates for IBC increased until 50 years and then flattened, whereas rates for LABC increased for all ages. When rates for LABC were stratified by estrogen receptor-positive (ERP) and -negative (ERN) expression, rates for ERP and ERN diverged, that is, rates for ERP increased with advancing age, whereas rates for ERN flattened after 50 years. When rates for IBC were stratified by ER expression, rates for both ERP and ERN flattened after 50 years of age.Conclusion: IBC and LABC seemed to be distinct biologic entities, as indicated by different prognostic factor profiles and age-specific incidence rate patterns. Rates that increased before 50 years and then stabilized, possibly indicated that premenopausal exposures had a greater effect on maintaining rates for IBC than for LABC.