| Objective:To explore the clinicopathological characteristics,pathological complete response(p CR)correlation after neoadjuvant systemic therapy(NAST),and survival prognosis in both invasive ductal carcinoma with ductal carcinoma in situ(IDC-DCIS)and invasive ductal carcinoma(IDC)cohorts.Methods:The clinicopathological data of patients with primary breast cancer who were first diagnosed and treated in the Department of Breast Surgery,Affiliated Hospital of Southwest Medical University from January 1,2020 to December 31,2020 were collected.Clinicopathological data including menstrual status,nipple discharge,clinical stage,presence of calcification and DCIS,molecular typing,breast and axillary surgery,and pathological status after NAST were collected and analyzed retrospectively.In addition,the data of 31,504eligible primary breast cancer patients in the SEER database were included,and the Kaplan-Meier survival curve was used to analyze the overall survival(OS)of the two groups before and after propensity score matching(PSM).Count variables were analyzed by X~2 test,and quantitative variables were analyzed by t test or rank sum test.p<0.05 was considered statistically significant.Results:A total of 185 patients were collected,90(48.6%)in the IDC-DCIS group and 95(51.4%)in the IDC group.The average age of the total population was 50 years old.There were significant differences between the two groups in the presence of nipple discharge,T stage,N stage,presence of calcification,HER2 status,molecular typing,breast and axillary surgery(p<0.05),but no significant differences were found in menstrual status,histological grade and HR status.DCIS was associated with p CR after NAST in univariate analysis(p=0.041),but no statistical difference was found in multivariate analysis.31,504breast cancer patients were included in the SEER database,9,556 in the IDC group and 21,948 in the IDC-DCIS group.There were significant differences in molecular subtypes,T stage,N stage,ER,PR and HER2 status between the two groups(p<0.001).Using K-M curves to compare the OS of the two groups with a mean follow-up of 95 months,the analysis showed a survival advantage in the IDC-DCIS group over the IDC group(HR=0.730,95%CI:0.692-0.770,p<0.001),which persisted even after PSM in the IDC-DCIS group(HR=0.834,95%CI:0.785-0.886,p<0.001).Conclusion:Compared with IDC,IDC-DCIS patients were more likely to present with nipple discharge,calcifications on mammography,small tumors,axillary lymph node negative status,and HER2-positive tumors,while more IDC-DCIS patients underwent mastectomy and sentinel lymph node biopsy.Invasive breast cancer patients with carcinoma in situ may have a better prognosis.In addition,the presence of DCIS in tumors may not be an independent prognostic factor for p CR after NAST. |
