Clinical And Pathological Features And Prognosis Of 54 Patients With Mucinous Brreast Carciinoma

Objective:To analyze the clinicopathological features of patients with mucinous breast carcinoma（MBC）and the factors influencing its prognosis,so as to provide reference for individualized treatment and prognosis of clinical mucinous breast carcinoma patients.Methods:The clinical and pathological data of 54 cases of female mucinous breast carcinoma treated by surgery in Cancer Hospital Affiliated To Guangxi Medical University from 2008-01-01 to 2017-07-01 were retrospectively analyzed.According to the pathological types,it was divided into pure mucinous breast carcinoma（PMBC）and mixed mucinous breast carcinoma（MMBC）.The clinical and pathological characteristics of MBC patients including age,menopausal status,TNM stage,T stage,axillary lymph node metastasis,hormone receptor status and HER-2 expression were summarized and analyzed,and the adjuvant treatment scheme and prognosis were analyzed.and application of Kaplan Meier-method to calculate the disease-free Survival of patients andthe adjuvant treatment of patients with MBC were analyzed,Kaplan-Meier method was used to calculate the disease free survival（DFS）and overall survival（OS）of patient,and survival curves were drawn based on the results.The log-rank test was used for univariate analysis of relevant clinicopathological features,and Cox’s proportional hazards regression model was used for multivariate analysis.Results:The 54 MBC patients were 27 to 80 years old,with a median age of 43.5 years old.All patients were admitted to the hospital for painless breast lumps.among which 8 patients were younger than or equal to 35 years old,28patients were between 35 and 50 years old,and 18 patients were older than or equal to 50 years old.There were 26 cases of left breast mass and 28 cases of right breast mass.There were 31 cases in the outer upper quadrant,5 cases in the outer lower quadrant,15 cases in the inner upper quadrant,and 3 cases in the inner lower quadrant.There were 39 cases before menopause and 15 cases after menopause.TNM staging:there were16 cases inⅠstage,32 cases inⅡstage,6cases inⅢstage.There were 17 cases in T₁ stage,29 cases in T₂ stage,and 8cases in T₃ stage.There were 14 cases（25.9%）with positive axillary lymph node metastasis,49 cases（90.7%）with ER positive,43 cases（79.6%）with PR positive,5 cases（9.3%）with HER-2 positive.38 cases was pure mucinous breast carcinoma（PMBC）and 16 cases was mixed mucinous breast carcinoma.The ratio of PMBC groupⅠandⅡstage is higher than MMBC group（97.4%vs 68.8%）（P=0.008,P<0.05）.The ratio of PMBC group T₃ stage is lower than MMBC group（7.9%vs 31.3%）（P=0.045,P<0.05）.Axillary lymph node metastasis in PMBC group was lower than MMBC group（10.5%vs.62.5%）（P=0.000,P<0.05）.The PR positivity of PMBC group was higher than that of MMBC group（86.8%vs 62.5%）（P=0.043,P<0.05）.PMBC group only has 1 case with HER-2 positive,while MMBC group has 4 cases with HER-2 positive（P=0.038,P<0.05）.There was no difference between the two groups in age,postmenopausal status,tumor size,ER expression,surgical method,chemotherapy,radiotherapy and endocrine therapy（P>0.05）.The median follow-up was 77.5 months.Local recurrence or metastasis occurred in 7 patients,and 2 patients died.The 5-year DFS rate of MBC was85%,5-year OS rate of MBC was 95.5%.Kaplan-meier analysis showed that there was no significant difference in DFS and OS among MBC patients with different treatment methods（P<0.05）.But there were statistically significant differences in DFS and OS between PMBC and MMBC（P<0.05）.Kaplan-meier survival curve showed that DFS and OS of PMBC was better than MMBC.The analysis of log-rank test showed that TNM stage,T stage and axillary lymph node metastasis were the influencing factors of DFS and OS in MBC patients.The analysis of Cox’s proportional hazards regression model showed that axillary lymph node metastasis was an independent risk factor affecting DFS in MBC patients.Conclusions:（1）Patients with MBC had earlier TNM stage,high expression of hormone receptors,low positive rate of HER-2 and axillary lymph node metastasis,and a good prognosis.（2）The positive rates of HER-2 and axillary lymph node metastasis in MMBC patients were higher than PMBC patients,T staging was higher than that in PMBC patients,and TNM staging was later than PMBC patients.（3）The DFS and OS of PMBC patients were better than those of MMBC patients.Axillary lymph node metastasis is an independent risk factor affecting the DFS of MBC patients.