Difference in characteristics and outcomes between medullary breast carcinoma and invasive ductal carcinoma: a population based study from SEER 18 database

Abstract

Medullary breast carcinoma (MBC) is a unique histological subtype of breast cancer. Our study was designed to identify difference in characteristics and outcomes between MBC and invasive ductal carcinoma (IDC), and further confirm the prognostic factors of MBC. Utilizing Surveillance, Epidemiology, and End Results (SEER), we identified 84,764 eligible patients, including 309 MBC and 84,455 IDC. Compared with the IDC group, the MBC group was associated with younger age at diagnosis, higher grade, more advanced stage, larger tumor size, and higher proportion of triple-negative breast cancer (TNBC). Kaplan-Meier analysis and univariate Cox proportional hazard regression model showed that patients with IDC had significantly better breast cancer-specific survival (BCSS) compared to MBC, but they had similar overall survival (OS). However, MBC histology was no longer a surrogate for worse BCSS or OS after 1:1 matching by age, American Joint Committee on Cancer (AJCC) stage, grade and breast subtype. In addition, it was exposed that not married status, high grade, large tumor size, positive nodal status, the subtype of TNBC and no receipt of radiation therapy were significantly associated with poor BCSS and OS. In conclusion, MBC demonstrated more aggressive behavior but similar outcomes compared to IDC, which may be determined by prognostic factors such as breast subtype. These results not only confer deeper insight into MBC but contribute to individualized and tailored therapy, and thereby may improve clinical management and outcomes.

Typical medullary breast carcinoma: clinical outcomes and treatment results

“…This result is in accordance with the observations of many authors who emphasis that patients with this advanced stage of the disease clearly predominate in percentage terms [2,10,18,21,22,24,25,[28][29][30]. According to certain authors, patients with stages I and II° of the disease represent more than 90% of the total.…”

“…Similar population, microscopic and clinical characteristics, as well as immunohistochemically studied factors can be found quite often in the literature, obviously in varying frequency and intensity [1,2,15,17,18,[21][22][23][24][25][26][27][28][29][30]. However, it is important to stress that making strict comparisons between the present study group of patients and groups presented by other authors is very difficult and remains a questionable approach, since a T-MBC diagnosis itself is problematic and controversial.…”

“…Immunohistochemically T-MBC is usually characterised by features typical of basal-like carcinomas; they do not express oestrogen, progesterone and HER 2/neu receptors. Hence, they were included in so-called "triple-negative" breast carcinomas [1,[5][6][7][12][13][14][15][16][17][18][19][20][21].…”

Genomic landscape of small cell carcinoma of the breast contrasted to small cell carcinoma of the lung

“…Hormone receptor expression varies across the different histological types [21]. Utilizing Surveillance, Epidemiology, and End Results, a recent analysis demonstrated that the majority of invasive ductal carcinoma not otherwise specified was hormone receptorpositive but HER2 negative, while the majority of medullary carcinoma was triple negative [22]. Out of the patients in this study with small cell carcinoma of the breast; 31 % expressed ER, 13 % expressed PR, and 16 % expressed AR.…”

The Ratio of Medullary Breast Carcinoma (MBC) to Invasive Ductal Carcinoma (IDC) is Comparable in Developed and Underdeveloped Countries

“…Incidentally, the literature also revealed the trend towards comparing MBC and invasive ductal carcinoma (IDC). Thus, from Korea [12], India [13] and China [14], there have been decisive comparisons. For instance, the last named authors were emphatic concerning the "Difference in characteristics and outcomes between medullary breast carcinoma and invasive ductal carcinoma.…”