The Demographic Features, Clinicopathological Characteristics and Cancer-specific Outcomes for Patients with Microinvasive Breast Cancer: A SEER Database Analysis

Abstract

To investigate the clinicopathological characteristics and survival outcomes of microinvasive breast cancer, we conducted an observational study of female diagnosed with DCIS or DCIS with microinvasion (DCISM) from 1990 to 2012 using the Surveillance, Epidemiology, and End Results (SEER) database. There were 87695 DCIS and 8863 DCISM identified. In DCISM group, patients appeared to be younger and more black patients were identified in comparison with DCIS group. Furthermore, DCISM was associated with more aggressive tumor characteristics like higher rates of oestrogen receptor (ER) and progesterone receptor (PR) negativity, HER2 positivity, and lymph node metastasis. With a median follow-up of 91 months, patients with DCISM had worse cancer-specific survival (CSS) (hazard ratio [HR], 2.475; P < 0.001) and overall survival (OS) (HR, 1.263; P < 0.001). In the multivariable analysis, microinvasion was an independent prognostic factor for worse CSS (HR, 1.919; P < 0.001) and OS (HR, 1.184; P < 0.001). The 10-year cancer-specific mortality rate was 1.49% in DCIS and 4.08% in DCISM (HR, 2.771; P < 0.001). The 20-year cancer-specific mortality rate was 4.00% in DCIS and 9.65% in DCISM (HR, 2.482; P < 0.001). Deepening understanding of the nature of microinvasive breast cancer will be valuable for clinical treatment recommendations.

Sentinel lymph node biopsy in patients affected by breast ductal carcinoma in situ with and without microinvasion

“…[28–30] Our results confirmed previous studies that showed a reduced OS in DCISM than DCIS. [28,29] In addition, several studies suggested that DCISM survival outcomes were intermediate between DCIS and IDC, while in our study we found it to be very similar to IDC, mainly because of distant metastases occurrence. [30,31]…”

Sentinel lymph node biopsy in microinvasive ductal carcinomain situ

“…A number of relevant studies have investigated the histopathological characteristics and clinical outcomes of microinvasive DCIS; how patient survival and the biological behaviour of this rare form of breast carcinoma differ from DCIS remain controversial. Microinvasive DCIS is frequently found in a high nuclear grade comedo DCIS setting, and less frequently with other types of DCIS or lobular carcinoma in situ .…”

Breast Microinvasive Carcinoma With Different Morphologies: Analysis of Clinicopathologic Features of 121 Cases

“…In this study, the positive rates of ER and PR were lower than those reported in the literature, while the positive rates of HER2 were higher than those reported in the literature, which may be related to race, or the proportion of high-grade DCIS in this study was higher. 17 In this study, there was no difference in hormone status between the 2 forms of MI.…”