Clinicopathological Features And Prognosis Of Mucinous Carcinoma Of The Breast

Objective: In this study,we aimed to analyze the clinicopathological features,treatment methods and survival prognosis of patients with mucinous breast carcinoma(MBC),and to explore whether the corresponding treatment strategies should be developed according to different subtypes of MBC,so as to guide clinical treatment.Methods: A total of 274 MBC patients who underwent surgery ar the Breast Center of the Fourth Affiliated Hospital of Hebei Medical U niversity between January 2011 to January 2016 were selected.All histo logical sections were diagnosed as Pure mucinous breast carcinoma(PMB C),Mixed mucinous breast carcinoma(MMBC),PMBC was divided into hypocellular PMBC(PMBC-A)and hypercellular PMBC(PMBC-B).The c linicopathological characteristics,treatment modalities and survival progn osis were compared among the MBC subytypes.Results:1.The high prevalence of MBC patients was in postmenopausal patients(74.80%),the disease duration was mostly more than 3 months(58.40%),and the mean diameter of tumor was 2.6cm(0.3-11 cm;median,2.3cm),Luminal A type(36.14%),Luminal B type(42.34%).The percentage of MMBC and PMBC patients presenting lymph node metastasis was 72% and 15.26%,HER-2 receptor positively was 24.00% and 10.04%,and TNM stage I-II was88.00% and 93.57%.MMBC had a higher rate of lymph node metastasis than PMBC patients,a higher rate of positive HER-2 receptor positivity,and a later TNM stage.There was no significant difference in age,tumor size,ER,PR expression and Ki-67.Moreover,There was no significant difference in clinicopathological features between PMBC-A and PMBC-B.2.69 patients with PMBC(27.71%)and 1 patient with MMBC(4.00%)received breast-conserving surgery;17 patients with MMBC(68.00%)and 76 patients with PMBC(30.52%)received adjuvant chemotherap y,(P<0.05),There was no significant difference between the two groups of patients in terms of endocrine therapy,radiotherapy,and targeted ther apy,(P>0.05).no significant difference was seen between the two groups of patients with PMBC-A and PMBC-B for various treatment modalitie s(P > 0.05).3.The 5-year DFS of PMBC and MMBC,was 96.38% and 76.00%,The5-year OS was 99.1970% and 88.00%.PMBC had better DFS(P =0.0001)and OS(P =0.0003)than MMBC.The 5-year DFS of PMBC-A and PMBC-B,was98.97% and 87.03%,The 5-year OS was 98.97% and 87.03%.PMBC-A had better DFS than PMBC-B(P=0.001),but the difference in OS was not statistically significant(P=0.0526).Analysis of prognostic factors showed that tumor size,lymph node status and ER expression status were independent prognostic factors affecting DFS in patients with MBC,lymph node status and ER expression status were independent prognostic factorsaffecting OS in patients with MBC.Conclusions:1.MMBC had a higher rate of lymph node metastasis,a higher rate of HER-2 positive expression,and a later TNM stage than PMBC.2.More PMBC patients received breast-conserving surgery than MMBC patients,and more MMBC patients received adjuvant chemotherapy than PMBC patients.3.The prognosis of PMBC type is better than that of MMBC type,and the prognosis of PMBC-A type is better than that of PMBC-B type.4.Tumor size,lymph node status and ER expression status are independent prognostic factors affecting DFS in MBC patients,while lymph node status and ER expression status are independent prognostic factors affecting OS in MBC patients.Therefore,MBC as a histological type with favorable prognosis,has differences in prognosis among its subtypes,and corresponding treatment strategies should be considered according to its subtypes.