Prognosis of medullary breast cancer: analysis of 13 International Breast Cancer Study Group (IBCSG) trials
Annals of Oncology, 06/19/2012
Huober J et al. – Medullary tumors have a favorable prognosis compared with invasive ductal tumors.Methods
- Among 12 409 patients, 127 were recorded as invasive medullary tumors and 8096 invasive ductal tumors.
- Medullary and ductal invasive tumors were compared with regard to stage, age at diagnosis, grade, hormone receptor status, peritumoral vascular invasion, and local and systemic treatment.
- Pattern of relapse, distant recurrence-free interval (DRFI), and overall survival (OS) were determined for both histological groups.
- Two cohorts were investigated: a full cohort including the pathologist-determined medullary histology without regard to any other tumor features and a cohort restricted to patients with ER-negative grade 3 tumors. Results
- Fourteen-year DRFI and OS percents for medullary tumors (n = 127) and invasive ductal tumors (n = 8096) of the full cohort were 76% and 64% [hazard ratio (HR) 0.52, P = 0.0005] and 66% and 57% (HR = 0.75, P = 0.03), respectively.
- For the restricted cohort, 14-year DRFI and OS percents for the medullary (n = 47) and invasive ductal tumors (n = 1407) were 89% and 63% (HR 0.24, P = 0.002) and 74% and 54% (HR = 0.55, P = 0.01), respectively.
- Competing risk analysis for DRFI favored medullary tumors (HR medullary/ductal = 0.32; 95% confidence interval = 0.13–0.78, P = 0.01).