Clinical Nomogram for Predicting Survival Outcomes in Early Mucinous Breast Cancer

Abstract

BackgroundThe features related to the prognosis of patients with mucinous breast cancer (MBC) remain controversial. We aimed to explore the prognostic factors of MBC and develop a nomogram for predicting survival outcomes.MethodsThe Surveillance, Epidemiology, and End Results (SEER) database was searched to identify 139611 women with resectable breast cancer from 1990 to 2007. Survival curves were generated using Kaplan-Meier methods. The 5-year and 10-year cancer-specific survival (CSS) rates were calculated using the Life-Table method. Based on Cox models, a nomogram was constructed to predict the probabilities of CSS for an individual patient. The competing risk regression model was used to analyse the specific survival of patients with MBC.ResultsThere were 136569 (97.82%) infiltrative ductal cancer (IDC) patients and 3042 (2.18%) MBC patients. Patients with MBC had less lymph node involvement, a higher frequency of well-differentiated lesions, and more estrogen receptor (ER)-positive tumors. Patients with MBC had significantly higher 5 and10-year CSS rates (98.23 and 96.03%, respectively) than patients with IDC (91.44 and 85.48%, respectively). Univariate and multivariate analyses showed that MBC was an independent factor for better prognosis. As for patients with MBC, the event of death caused by another disease exceeded the event of death caused by breast cancer. A competing risk regression model further showed that lymph node involvement, poorly differentiated grade and advanced T-classification were independent factors of poor prognosis in patients with MBC. The Nomogram can accurately predict CSS with a high C-index (0.816). Risk scores developed from the nomogram can more accurately predict the prognosis of patients with MBC (C-index = 0.789) than the traditional TNM system (C-index = 0.704, P< 0.001).ConclusionsPatients with MBC have a better prognosis than patients with IDC. Nomograms could help clinicians make more informed decisions in clinical practice. The competing risk regression model, as a more rational model, is recommended for use in the survival analysis of patients with MBC in the future.

Epidemiology and survival outcomes of mucinous adenocarcinomas: A SEER population-based study

“…Several studies have indeed shown a worse survival in colorectal MACs 6 , 7 , whereas others did not identify any adverse prognostic effect 8 , 9 . However, for mucinous breast cancer, nearly all studies uniformly reached the same conclusion, suggesting that individuals with this cancer type have a better outcome than patients with infiltrating ductal carcinoma 10 – 12 . Debates have persisted regarding the relationship between the primary tumor site and cancer-specific survival in MAC cases.…”

Whole‐lesion histogram analysis of the apparent diffusion coefficient: Evaluation of the correlation with subtypes of mucinous breast carcinoma

“…Mucinous breast carcinoma (MBC), a type of breast cancer characterized by a large amount of extracellular mucin, has a reported incidence ranging from 1–7% among all primary breast cancers . MBC presents favorable clinical and pathologic characteristics in terms of hormone receptor status, tumor grade, and lymph node (LN) involvement and is characterized by a favorable prognosis and excellent long‐term survival …”

“…cer characterized by a large amount of extracellular mucin, has a reported incidence ranging from 1-7% among all primary breast cancers. [1][2][3][4] MBC presents favorable clinical and pathologic characteristics in terms of hormone receptor status, tumor grade, and lymph node (LN) involvement 5 and is characterized by a favorable prognosis and excellent longterm survival. 6,7 MBC is further divided into pure MBC (PMBC) and mixed MBC (MMBC) subgroups according to the quantification of tumor cellularity by the World Health Organization (WHO).…”

Clinicopathologic characteristics of HER2-positive pure mucinous carcinoma of the breast

“…PMC generally shows favorable prognosis. However, some studies reported that ER/PR negativity and high grade are associated with a poor prognosis in PMC [11,12].…”