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Short‐term and long‐term clinical outcomes of uncommon types of invasive breast cancer
Author(s) -
Yang Mu,
Bao Wei,
Zhang Xinmin,
Kang Yibin,
Haffty Bruce,
Zhang Lanjing
Publication year - 2017
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.13328
Subject(s) - medicine , invasive lobular carcinoma , breast cancer , hazard ratio , oncology , radiation therapy , proportional hazards model , epidemiology , cancer , carcinoma , gynecology , invasive ductal carcinoma , confidence interval
Aims Invasive ductal carcinoma ( IDC ) and invasive lobular carcinoma ( ILC ) are predominant and well‐documented types of invasive breast cancer ( IBC ). We investigated the clinical outcomes of other types of IBC (i.e. uncommon IBC ), which collectively account for Σ20% of all IBC cases, as these are largely unknown. Methods and results We identified all IBC cases diagnosed in 2004–2006 ( n = 159 293) and 2010–2011 ( n = 118 822) from the Surveillance, Epidemiology and End Results ( SEER ) database. Uncommon IBC s included mixed IDC and ILC ( MDLC ), IDC mixed with other types of carcinoma, ILC mixed with other types of carcinoma, and other‐type breast cancers ( OC s). We estimated overall survival ( OS ) and cancer‐specific survival in multivariate regression models. As compared with IDC , MDLC was associated with an increased OS [adjusted hazard ratio ( aHR ) = 0.92, P < 0.001 at Σ10 years of follow‐up; aHR = 0.88, P = 0.01 at Σ4 years of follow‐up], whereas OC s were associated with a decreased OS ( aHR = 1.06, P = 0.005 at Σ10 years of follow‐up; aHR = 1.23, P < 0.001 at Σ4 years of follow‐up). Women with other uncommon IBC s had an OS similar to those with IDC . Heterogeneity in survival was observed for some subtypes of OC , with better OS for women with MDLC and tubular carcinoma. Radiotherapy extended OS for all types of IBC in older women (≥50 years). For younger women (<50 years), radiotherapy improved OS in women with IDC , but not in those with ILC or uncommon IBC . Radiotherapy did not change cancer‐specific survival of younger women with any IBC. Conclusions Uncommon IBC s have distinct patterns of prognosis and survival. The effectiveness of radiotherapy in women with uncommon IBC may differ by age. The underlying mechanisms warrant further studies.