Clinicopathological features and prognostic factors of breast secretory carcinoma
Objective To investigate the clinical features and prognostic factors of secretory breast carcinoma(SBC),and to provide reference for the clinical treatment of SBC.Methods Using the Nation-al Cancer Institute Surveillance,Epidemiology,and End Outcomes(SEER)database,the clinical data of 79 patients with SBC and 461 750 patients with invasive ductal carcinoma were selected from January 2004 to December 2020.The clinicopathologic features and survival of the two groups were analyzed retrospec-tively.The COX analysis was done to determine the influencing factors of overall survival(OS)and breast cancer specific survival(BCSS).The propensity score matching method(PSM)was used to balance con-founding factors in a 1∶1 ratio,and Kaplan-Meier method was used to analyze the survival difference be-tween the two matched groups.Results There were differences between patients with SBC and those with invasive ductal carcinoma in terms of age(Z=27.887,P＜0.01),marital status(x2=9.639,P＜0.01),estrogen receptor(x2=4.873,P＜0.05),progesterone receptor(x2=42.917,P＜0.01),histological grade(Z=5.442,P＜0.01),and N staging(Z=2.616,P＜0.01).There was no statistically significant difference in terms of gender,race,tumor location,T staging,M staging,surgery,radiotherapy,and chemotherapy(P＞0.05).COX regression indicated that patients with SBC had a better prognosis[hazard ratio(HR)=1.616,95％confidence interval(CI):1.589-0.871,P＜0.05].The higher the histological grade,the worse the prognosis(HR for histological grade Ⅱ=1.159,95％CI:1.133-1.186,P＜0.01;HR for histological grade Ⅲ=1.440,95％CI:1.406-1.476,P＜0.01).The larger the tumor size,the worse the prognosis(HR for T2 staging=1.616,95％CI:1.589-1.643,P＜0.01;HR for T3 staging=2.188,95％CI:2.130-2.249,P＜0.01;HR for T4 staging=2.484,95％CI:2.416-2.554,P＜0.01).Patients with more lymph node metastasis had a poor prognosis(HR for N1 staging=1.426,95％CI:1.402-1.451,P＜0.01;HR for N2 staging=2.079,95％CI:2.028-2.131,P＜0.01;HR for N3 staging=2.576,95％CI:2.054-2.649,P＜0.01).When SBC and IDC were matched in the ratio of 1∶1,there was no statistically significant difference in OS and BCSS in both groups(HR=1.816,95％CI:0.785-4.205;HR=0.928,95％CI:0.232-3.721,P＞0.05).Conclusion SBC is a rare clinical malignant tumor with slow growth,low histological grade and less metastasis.Histological grade,tumor volume and lymph node metastasis were the prognostic factors.
Breast cancerSecretory carcinomaPathological featuresPrognosis
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