Study On The Characteristics Of Invasive Micropapillary Carcinoma Of Breast

Objective:This paper mainly obtains the population of IMPC patients from 2010 to 2015 through SEER database.we develop and validate the clinical prediction model of Overall survival of 3 years and 5 years of IMPC through internal verification method.we obtain the population of IMPC and IDC patients from 2010 to 2016.we want to compare and analyze the prognosis between IMPC and IDC in order to provide guidance for clinical treatment.Methods:The population in Surveillance,Epidemiology,and End Results(SEER)database was screened by strict inclusion and exclusion criteria,and the included population was randomly divided into Primary Cohort and verification Cohort according to the method of random resampling.Cox regression competitive risk model was used to establish the clinical prediction model of 3 years and 5 years Overall survival of IMPC.The IMPC nomogram was obtained by internal and external verification through the C-index,area under ROC curve and calibration.Through the SEER database from 2010 to 2016,IMPC and IDC patients were included and excluded,and the characteristics were analyzed.In order to further control the potential baseline confounding factors,according to the type of variable:race,age,site of first episode,left and right,histological grade,pTstage,pNstage,stage,ER,PR,HER-2,molecular classification,radiotherapy and chemotherapy,the(PSM),usage ratio at 1:1 was analyzed,and the standard deviation of Logit was0.0.After pairing,the prognosis of OS and BCSS was analyzed by multivariate analysis.Use R software and SPSS software to analyze the data and draw a conclusion.Results:1.In the total population of IMPC,The percentage of female patients was 98.2%.The average age is 61.54 years old.(22-93 years old),and The percentage of 79.8%are 50-84 years old.The percentage of ER positive was 90.6%,the percentage of PR positive was 80.7%,and the HER-2 negative was 78%.The median survival month was 23.25 months(0-70 months).2.Compared with invasive ductal cancer,T3 and T4 accounted for a higher proportion of IDC patients(9.7% vs 6.3%),N2 and N3 accounted for a higher proportion(16.1% vs 7.1%),there were more patients in pathological stage 3(19.7%vs 10.0%);ER and PR positive people were higher(91.4% vs 81.7%,81.3% vs71.5%).3.Multivariate analysis of IMPC patients showed that: MI(HR(95%CI):1.573(0.4503-3.4940);P=0.000476);no surgery((HR(95%CI): 4.498(2.0340-9.948)P=0.0002),married(HR(95%CI): 0.2923(0.1243-0.6874);P= 0.0048)is the prognostic factor of invasive micropapillary carcinoma.The 3 years and 5 years OS prognostic nomogram was established.The weighted total score calculated according to each variable was used to estimate the 3 years and 5 years overall survival predictions,the C-index of the internal model group was 0.853,and the C-index of the verification group was 0.957.The area under the ROC curve of the verification group was that the AUC=0.946,calibration curve crossed and coincided with the 45 °dotted line,and the clinical model test performance was better.4.Comparative analysis of prognosis between invasive micropapillary carcinoma and invasive ductal carcinoma showed that the overall survival and breast cancer-specific survival of IMPC were better than those of IDC,(OS:(HR(95%CI):1.408(1.046 murl 1.896));BCSS;(HR(95%CI 0.024): 1.934(1.19853.121)pp0.007))5.The subgroup analysis showed that,The overall survival of IMPC is better than that of invasive ductal carcinoma in people older than 50 years(HR(95%CI):2.11(1.348-3.302)P=0.001),GII(HR(95%CI):2.403(1.054-5.478)P=0.037),GIII(HR(95%CI):2.79(1.197-6.502)P=0.017),Radiotherapy(HR(95%CI: 1.761(1.355),P 2.287)P < 0.001)and chemotherapy(HR(95%CI): 1.594(1.225 pp2.074),P < 0.001)).Conclusion:IMPC has higher tumor volume,histological grade,higher lymph node infiltration rate in clinic.In the aspect of molecular typing,the positive rates of ER and PR were higher,but the more aggressive clinical manifestations and themolecular typing of ER and PR were not related to the overall survival and prognosis.Patients with IMPC should undergo thorough local examination and active treatment in order to accurately evaluate the local tumor status and provide appropriate and standardized treatment to minimize local recurrence.