Multivariate Analysis Of Clinicopathological Features And Prognosis Of Mucinous Breast Carcinoma

Objective: To investigate the prognosis of Mucinous breast carcinoma(MBC)and to study the risk factors of recurrence and metastasis,and to provide reference for individualized treatment of Mucinous breast carcinoma.Methods: The clinical and pathological data of 107 MBC patients who underwent surgical treatment in the First Affiliated Hospital of Dalian Medical University from January 2003 to December 2018 were retrospectively analyzed,including age,surgical method,tumor location,pathological stage,tumor diameter,axillary lymph node status,ER,PR,Her-2,Ki-67,etc.IBM SPSS 24.0 software was used for statistical analysis,mainly for survival analysis of MBC patients;MMBC with invasive ductal carcinoma,solid papillary carcinoma and intraductal carcinoma survival analysis of three pathological types;and to study the risk factors affecting the prognosis of MBC.Results: 1.Analysis of clinicopathological features: There were 57 cases(53.3%)of PMBC in 107 cases of MBC and 50 cases(46.7%)of MMBC.The average age of MBC patients was 57.5 years(26.9-90.1 years old,median age 58.5 years);the average diameter of tumors was 3.3 cm(0.6 cm-8 cm,median 2.9 cm),but T1 stage was common in MBC patients(59.1%).The clinical stage was common in stage I,with 55 cases(51.4%);9 cases(8.4%)with breast-conserving surgery and 98 cases(91.6%)with radical surgery.Of the 107 MBC patients,18(16.8%)had axillary lymph node metastasis.There were 101 cases(94.4%)and 95 cases(88.8%)of MBC patients with positive ER and PR,respectively.Of the 96 patients,only 6(6.2%)were positive for her-2.Among the 62 patients who underwent Ki-67,41(66.0%)had high Ki-67 expression.There was no significant difference in the expression status of PMBC and MMBC in age,surgical procedure,clinical stage,tumor location,tumor size,ER,PR,Her-2,and Ki-67(P>0.05).The axillary lymph node metastasis rate of MMBC(24.0%)was significantly higher than that of PMBC(8.8%)(P<0.05).2.Prognosis analysis: The 5-year and 10-year DFS of MBC patients were 92.9%,5-year OS and 10-year OS were 92.5% and 84.1%,respectively.The 5-year DFS of patients with PMBC and MMBC were 97.5% and 86.0%,respectively;the 5year OS was 97.1% and 85.9%,respectively;the 10-year OS was 90.2% and 71.6%,respectively.PMBC patients showed better DFS(P=0.049)and OS(P=0.029).In MMBC,the 5-year DFS of invasive ductal carcinoma,solid papillary carcinoma and intraductal carcinoma were 79.9%,83.3% and 100%,respectively(P=0.475);the 5-year OS was 80.8%,83.3% and 100%(P = 0.438);The trend of DFS and OS in mixed mucinous carcinoma with invasive ductal carcinoma was significantly worse than that with other components.The 5-year DFS of the axillary lymph node positive group and the negative group were 78.3% and 96.0%,respectively;the 5-year OS was 76.9% and 95.9%,respectively;the 10-year OS was 65.9% and 89.1%,respectively.The DFS(P=0.008)and OS(P=0.012)of patients with mucinous breast carcinoma in the axillary lymph node positive group were worse than those in the axillary lymph node negative group.The overall survival rate of patients aged ?58.5 years was better than that of patients aged >58.5 years(P=0.043).There was no statistical significance in DFS and OS survival analysis according to the clinicopathological characteristics of MBC,tumor diameter,pathological stage,ER,PR,her-2,ki-67.3.Multivariate analysis: Multivariate analysis of MBC showed that DFS had no correlation with pathological type and axillary lymph node status;The main factors affecting patients' OS were pathological type,axillary lymph node status and age.Conclusion: The DFS of MBC patients were 92.9% at 5 and 10 years,and OS were 92.5% and 84.1% at 5 and 10 years,respectively.There was no significant difference in DFS and OS among MMBC patients with different components of carcinoma,but DFS and OS among MMBC patients with invasive ductal carcinoma were worse than those with solid papillary carcinoma and intraductal carcinoma.Therefore,individualized treatment should be considered in MMBC patients with components of other cancers.Compared with PMBC,patients with MMBC have higher rate of axillary lymph node metastasis,poor prognosis and higher risk of recurrence and metastasis.Therefore,enough attention should be paid to the treatment of MMBC.Univariate and multivariate analysis showed that the overall survival of MBC was related to pathological type,axillary lymph node status and patient age.