Different Clinicopathological Characteristics And Prognostic Factors For Occult And Non-occult Breast Cancer

Background and Purpose: Occult breast cancer(OBC)was a rare disease.The majority of the studies on OBC consisted of a small,single-institution sample size and mainly focused on the importance of local regional treatment in OBC.Only few studies have ever been conducted to evaluate the different clinicopathological characteristics and prognostic factors between OBC and non-OBC patients.Besides,these studies have yielded inconsistent results.Therefore,the aim of our study was to further evaluate the different clinicopathological characteristics and prognostic factors for occult and non-occult breast cancer.Methods:572 OBC patients and 117,217 non-OBC patients between 2004 and 2015was selected from Surveillance,Epidemiology,and End Results(SEER)database.We analyzed the clinicopathological characteristics and survival outcomes between OBC and non-OBC patients.Subgroup analysis was further carried out to explore the differences in survival.Furthermore,the propensity score matching method was utilized to reduce the influences of baseline differences in demographic and clinical characteristics on outcome differences.Univariable and multivariable analyses were used to evaluate the prognostic factors of OBC patients.Results: Compared with non-OBC patients,OBC patients in this study presented a higher proportion of older age,American Joint Committee on Cancer(AJCC)N3 stage,estrogen receptor(ER)-negative status,progesterone receptor(PR)-negative status,and human epidermal growth factor receptor-2(HER-2)-positive status,and underwent more chemotherapy.Multivariate analysis revealed a better survival in overall patients with OBC patients according to breast cancer-specific survival(BCSS)and overall survival(OS).Propensity score analysis also achieved a similar result for OBC patients.Stratified analyses by nodal status and molecular subtypes indicated that these survival advantage were mainly presented in patients with AJCC N2+N3 stage or hormone receptor(HR)-positive tumors.In addition,nodal status,HER-2 status and radiotherapy status were demonstrated to be three independent prognostic factors for OBC patients.Conclusion: Patients with OBC retained exclusive clinical characteristics and were shown to have a better outcome compared with non-OBC patients,especially for those with N2+N3 stage or HR-positive tumors.Nodal status,HER-2 status and radiotherapy status were demonstrated to be three independent prognostic factors for OBC patients.