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The impact of stage and histology on the long‐term clinical course of 163,808 patients with breast carcinoma
Author(s) -
Gamel John W.,
Meyer John S.,
Feuer Eric,
Miller Barry A.
Publication year - 1996
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19960415)77:8<1459::aid-cncr6>3.0.co;2-7
Subject(s) - medicine , stage (stratigraphy) , breast cancer , carcinoma , histology , lobular carcinoma , survival analysis , breast carcinoma , medullary cavity , survival rate , oncology , adenocarcinoma , cancer , ductal carcinoma , paleontology , biology
BACKGROUND Stage and histologic type have a significant impact on the long term clinical course of breast carcinoma. Clinical course is governed by two components: likelihood of cure and median tumor‐related survival time among uncured patients. Estimates of these components can be derived only by using survival models that incorporate cured fraction as a specific parameter. METHODS The prognostic value of stage and histologic type was determined for 163,808 patients with breast carcinoma using the log normal and log logit cure‐based survival models. Follow‐up ranged from 1 month to 19 years and was obtained from the SEER Program. RESULTS In approximate terms, ductal carcinoma was diagnosed in 70% of the patients, with estimated cured fractions of 2/3 and 1/3 for local, and regional disease, respectively. Estimates of median survival times for uncured patients were 10 and 5 years. Findings were similar for patients with tumors of miscellaneous histologic types. For patients with medullary carcinoma, cured fractions were relatively high at 82% and 64%, but median survival times were relatively short at 4 and 3 years. Corresponding values for patients with invasive comedo carcinoma were 82% and 50%, with median survival times of 6 and 4 years. For patients with mucinous, lobular, and ductolobular carcinomas, parametric analysis gave inconsistent estimates of cured fraction, but findings suggested unusually long tumor‐related survival times. CONCLUSIONS Cure‐based parametric survival models offer valuable insight into the impact of stage and histology on the clinical course of breast cancer. Cancer 1996; 77:1459‐64.