Öz
Amaç: Bu çalışmada kliniğimize başvuran özel tip meme kanseri tanılı hastaların klinik özelliklerini ve sağkalım sonuçlarını araştırdık.
Materyal-Metod: Cumhuriyet Üniversitesi Onkoloji Merkezi’ne 2010-2020 yılları arasında başvuran meme kanserli tüm nadir, histolojik olarak özel alt tip hastalarının demografik, klinikopatolojik ve sağkalım özellikleri retrospektif olarak incelenmiştir.
Bulgular: Çalışmada 1198 invaziv meme kanserli hastaların dosyaları incelenmiş ve bunlardan 104’ünün (8%) diğer histolojik özel alt tipinde olduğu tespit edilmiştir. Apokrin kanser 19 (8%), musinöz tip 19 (8%), invaziv kribriform 17 (%7), invaziv papiller 15 (%6), metaplastik tip 11 (%4), invaziv mikropapiller 9 (%4), nöroendokrin 6 (%2), tubuler tip 3 (%1), mikroinvaziv 3 (%1), undifferansiye 2 (%1) hastada saptanmıştır. Bu hastaların büyük bir kısmı 102 (98%)’ si kadın olup median yaşı 52 (26-82) bulunmuştur. Kadınların 60 (%59)’u postmenopozal, 42 (41%)’isi de premenopozaldir. 79 (76%) hastanın ECOG Performans skoru (PS) 0, 17 (16%)’sinin ECOG PS 1, 8 (8%)’inin ECOG PS 2 olarak izlenmiştir. Hastalar sorgulandığında 50’sinde (48%) komorbid hastalıklar olduğu, 26’sinde (25%) ailede meme kanseri öyküsü olduğu görülmüştür. Tanıda 25 (24%) hastanın evre I, 50 (48%) hastanın evre II ve 26 (25%) hastanın evre III, 3 (%3) hastanın evre IV olduğu tespit edilmiştir. Histopatolojik değerlendirmelere göre hastaların 75’inde (72%) estrogen reseptörü (ER) pozitif, 69’ünde (66%) progesterone reseptörü (PR) pozitif, 26’sında (25%) HER2-pozitif olarak bulunmuştur. İntraduktal component 54 (60%) hastada tespit edilmiştir. Multisentrisite 15 (16%) hastada izlenmiştir. 56 (54%) hastaya modifiye radikal mastektomi, 45 (43%) hastaya meme koruyucu cerrahi uygulanmıştır. 76 (73%) hastaya adjuvant kemoterapi, 73 (70%) hastaya hormonterapi ve 72 (68%) hastaya radyoterapi verilmiştir. Medyan takip 54 (1-201) ay olup takipte 13 (13%) hastada metastaz, 7 (7%) hastada nüks tespit edilmiş. Hastaların 5 ve 10 yıllık overall survival sırasıyla 86% ve 77% olup, 5 ve 10 yıllık event-free survival sırasıyla %79 ve %70 olarak bulunmuştur.
Sonuç: Çalışmamızda özel tip meme karsinomlu hastaların tamamına yakını nonmetastatik olup histopatolojik olarak hormon reseptörü pozitif ve düşük gradelidir. Özel tipler arasında, 5 ve 10 yıllık overall survival/ event-free survival istatistiki olarak anlamlı bulunmamıştır.
Anahtar Kelimeler
Kaynakça
- 1. WHO Classification of Tumours Editorial Board. Breast Tumours: World Health Organization classification of tumours. 2019; 5th ed. Lyon, France: IARC Press.
- 2. Rakha EA, Lee AH, Evans AJ. et al. Tubular carcinoma of the breast: Further evidence to support its excellent prognosis. J Clin Oncol. 2010; 28: 99–104.
- 3. Luini A, Aguilar M, Gatti G. et al. Metaplastic carcinoma of the breast, an unusual disease with worse prognosis: The experience of the European Institute of Oncology and review of the literature. Breast Cancer Res Treat. 2007; 101: 349–353.
- 4. Brenton JD, Carey LA, Ahmed AA, Caldas C. Molecular classiication and molecular forecasting of breast cancer: ready for clinical application? J Clin Oncol. 2005;23(29):7350–60.
- 5. Sorlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad 2001;98(19):10869–74.
- 6. Wolff AC, Hammond ME, Schwartz JN, Hagerty KL, Allred DC, Cote RJ, Dowsett M, Fitzgibbons PL, Hanna WM, Langer A, McShane LM, Paik S, Pegram MD, Perez EA, Press MF, Rhodes A, Sturgeon C, Taube SE, Tubbs R, Vance GH, van de Vijver M, Wheeler TM, Hayes DF; American Society of Clinical Oncology; College of American Pathologists. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. J Clin Oncol 2007;25(1):118-45.
- 7. Hammond ME, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, Fitzgibbons PL, Francis G, Goldstein NS, Hayes M, Hicks DG, Lester S, Love R, Mangu PB, McShane L, Miller K, Osborne CK, Paik S, Perlmutter J, Rhodes A, Sasano H, Schwartz JN, Sweep FC, Taube S, Torlakovic EE, Valenstein P, Viale G, Visscher D, Wheeler T, Williams RB, Wittliff JL, Wolff AC. American Society of Clinical Oncology/College Of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 2010;28(16):2784-95.
- 8. Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thürlimann B, Senn HJ; Panel members. Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol. 2011;22(8):1736-47.
- 9. Dellapasqua S, Maisonneuve P, Viale G et al. Immunohistochemically defined subtypes and outcome of apocrine breast cancer. Clin Breast Cancer 2013; 13:95–102.
- 10. Montagna E, Maisonneuve P, Rotmensz N et al. Heterogeneity of triple-negative breast cancer: Histologic subtyping to inform the outcome. Clin Breast Cancer 2013; 13:31–39.
- 11. Barkley CR, Ligibel JA, Wong JS et al. Mucinous breast carcinoma: a large contemporary series. Am J Surg 2008; 196(4): 549–51.
- 12. Pettinato G, Manivel CJ, Panico L. et al. Invasive micropapillary carcinoma of the breast: Clinicopathologic study of 62 cases of a poorly recognized variant with highly aggressive behavior. Am J Clin Pathol. 2004; 121: 857–866.
- 13. Chen L, Fan Y, Lang RG. et al. Breast carcinoma with micropapillary features: Clinicopathologic study and long-term follow-up of 100 cases. Int J Surg Pathol. 2008; 16: 155–163.
- 14. Pezzi CM, Patel-Parekh L, Cole K. et al. Characteristics and treatment of metaplastic breast cancer: Analysis of 892 cases from the National Cancer Data Base. Ann Surg Oncol. 2007; 14: 166–173.
- 15. Jung SY, Kim HY, Nam BH. et al. Worse prognosis of metaplastic breast cancer patients than other patients with triple-negative breast cancer. Breast Cancer Res Treat. 2010; 120: 627–637.
- 16. Al Sayed AD, El Weshi AN, Tulbah AM. et al. Metaplastic carcinoma of the breast clinical presentation, treatment results and prognostic factors. Acta Oncol. 2006; 45: 188–195.
- 17. Hennessy BT, Krishnamurthy S, Giordano S. et al. Squamous cell carcinoma of the breast. J Clin Oncol. 2005; 23: 7827–7835.
- 18. Makretsov N, Gilks CB, Coldman AJ et al. Tissue microarray analysis of neuroendocrine differentiation and its prognostic significance in breast cancer. Hum Pathol 2003; 34(10): 1001–1008. 28. Weigelt B, Horlings HM, Kreike B et al. Refinement of breast cancer classification by molecular characterization of histological special types. J Pathol 2008; 216(2): 141–150.
- 19. Sapino A, Papotti M, Righi L et al. Clinical significance of neuroendocrine carcinoma of the breast. Ann Oncol 2001; 12 (2): 115–7.
- 20. Liu XY, Jiong YZ, Liu YR, Zuo WJ. Clinicopathological Characteristics and Survival Outcomes of Invasive Cribriform Carcinoma of Breast A SEER Population-Based Study. Medicine 2015; 31:94.
Öz
Purpose: In this study, we investigated the clinical characteristics and survival outcomes of patients diagnosed with special types of breast cancer who presented to our clinic.
Material and Methods: The demographic, clinicopathological, and survival characteristics of all rare, histologically special subtype breast cancer patients who applied to Cumhuriyet University Oncology Center between 2010 and 2020 were retrospectively reviewed.
Results: The records of 1198 patients with invasive breast cancer were examined, and 104 of them (8%) were identified as having other histological special subtypes. Of these, 19 (8%) had apocrine cancer, 19 (8%) had mucinous type, 17 (7%) had invasive cribriform, 15 (6%) had invasive papillary, 11 (4%) had metaplastic type, 9 (4%) had invasive micropapillary, 6 (2%) had neuroendocrine, 3 (1%) had tubular type, 3 (1%) had microinvasive type, and 2 (1%) had undifferentiated carcinoma. The majority of these patients, 102 (98%), were female, with a median age of 52 years (range 26-82). Of the women, 60 (59%) were postmenopausal, and 42 (41%) were premenopausal. The ECOG Performance Score (PS) was 0 in 79 (76%) patients, 1 in 17 (16%) patients, and 2 in 8 (8%) patients. Upon evaluation, 50 patients (48%) had comorbid conditions, and 26 patients (25%) had a family history of breast cancer. At diagnosis, 25 patients (24%) were stage I, 50 (48%) were stage II, 26 (25%) were stage III, and 3 (3%) were stage IV. Histopathologically, 75 patients (72%) were estrogen receptor (ER)-positive, 69 (66%) were progesterone receptor (PR)-positive, and 26 (25%) were HER2-positive. An intraductal component was detected in 54 (60%) patients, and multicentricity was observed in 15 (16%) patients. A modified radical mastectomy was performed on 56 (54%) patients, while breast-conserving surgery was performed on 45 (43%) patients. Adjuvant chemotherapy was administered to 76 (73%) patients, hormonal therapy to 73 (70%), and radiotherapy to 72 (68%). The median follow-up period was 54 months (range 1-201). During follow-up, metastasis was detected in 13 patients (13%), and recurrence was detected in 7 patients (7%). The 5-year and 10-year overall survival rates were 86% and 77%, respectively, while the 5-year and 10-year event-free survival rates were 79% and 70%, respectively.
Conclusion: In our study, the majority of patients with special type breast carcinoma were non-metastatic, and histopathologically, they were hormone receptor-positive with low grade. There was no statistically significant difference in 5-year and 10-year overall survival or event-free survival among the special types.
Anahtar Kelimeler
Breast Cancer Special types of breast cancer overall survival event-free survival
Kaynakça
- 1. WHO Classification of Tumours Editorial Board. Breast Tumours: World Health Organization classification of tumours. 2019; 5th ed. Lyon, France: IARC Press.
- 2. Rakha EA, Lee AH, Evans AJ. et al. Tubular carcinoma of the breast: Further evidence to support its excellent prognosis. J Clin Oncol. 2010; 28: 99–104.
- 3. Luini A, Aguilar M, Gatti G. et al. Metaplastic carcinoma of the breast, an unusual disease with worse prognosis: The experience of the European Institute of Oncology and review of the literature. Breast Cancer Res Treat. 2007; 101: 349–353.
- 4. Brenton JD, Carey LA, Ahmed AA, Caldas C. Molecular classiication and molecular forecasting of breast cancer: ready for clinical application? J Clin Oncol. 2005;23(29):7350–60.
- 5. Sorlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad 2001;98(19):10869–74.
- 6. Wolff AC, Hammond ME, Schwartz JN, Hagerty KL, Allred DC, Cote RJ, Dowsett M, Fitzgibbons PL, Hanna WM, Langer A, McShane LM, Paik S, Pegram MD, Perez EA, Press MF, Rhodes A, Sturgeon C, Taube SE, Tubbs R, Vance GH, van de Vijver M, Wheeler TM, Hayes DF; American Society of Clinical Oncology; College of American Pathologists. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. J Clin Oncol 2007;25(1):118-45.
- 7. Hammond ME, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, Fitzgibbons PL, Francis G, Goldstein NS, Hayes M, Hicks DG, Lester S, Love R, Mangu PB, McShane L, Miller K, Osborne CK, Paik S, Perlmutter J, Rhodes A, Sasano H, Schwartz JN, Sweep FC, Taube S, Torlakovic EE, Valenstein P, Viale G, Visscher D, Wheeler T, Williams RB, Wittliff JL, Wolff AC. American Society of Clinical Oncology/College Of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 2010;28(16):2784-95.
- 8. Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thürlimann B, Senn HJ; Panel members. Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol. 2011;22(8):1736-47.
- 9. Dellapasqua S, Maisonneuve P, Viale G et al. Immunohistochemically defined subtypes and outcome of apocrine breast cancer. Clin Breast Cancer 2013; 13:95–102.
- 10. Montagna E, Maisonneuve P, Rotmensz N et al. Heterogeneity of triple-negative breast cancer: Histologic subtyping to inform the outcome. Clin Breast Cancer 2013; 13:31–39.
- 11. Barkley CR, Ligibel JA, Wong JS et al. Mucinous breast carcinoma: a large contemporary series. Am J Surg 2008; 196(4): 549–51.
- 12. Pettinato G, Manivel CJ, Panico L. et al. Invasive micropapillary carcinoma of the breast: Clinicopathologic study of 62 cases of a poorly recognized variant with highly aggressive behavior. Am J Clin Pathol. 2004; 121: 857–866.
- 13. Chen L, Fan Y, Lang RG. et al. Breast carcinoma with micropapillary features: Clinicopathologic study and long-term follow-up of 100 cases. Int J Surg Pathol. 2008; 16: 155–163.
- 14. Pezzi CM, Patel-Parekh L, Cole K. et al. Characteristics and treatment of metaplastic breast cancer: Analysis of 892 cases from the National Cancer Data Base. Ann Surg Oncol. 2007; 14: 166–173.
- 15. Jung SY, Kim HY, Nam BH. et al. Worse prognosis of metaplastic breast cancer patients than other patients with triple-negative breast cancer. Breast Cancer Res Treat. 2010; 120: 627–637.
- 16. Al Sayed AD, El Weshi AN, Tulbah AM. et al. Metaplastic carcinoma of the breast clinical presentation, treatment results and prognostic factors. Acta Oncol. 2006; 45: 188–195.
- 17. Hennessy BT, Krishnamurthy S, Giordano S. et al. Squamous cell carcinoma of the breast. J Clin Oncol. 2005; 23: 7827–7835.
- 18. Makretsov N, Gilks CB, Coldman AJ et al. Tissue microarray analysis of neuroendocrine differentiation and its prognostic significance in breast cancer. Hum Pathol 2003; 34(10): 1001–1008. 28. Weigelt B, Horlings HM, Kreike B et al. Refinement of breast cancer classification by molecular characterization of histological special types. J Pathol 2008; 216(2): 141–150.
- 19. Sapino A, Papotti M, Righi L et al. Clinical significance of neuroendocrine carcinoma of the breast. Ann Oncol 2001; 12 (2): 115–7.
- 20. Liu XY, Jiong YZ, Liu YR, Zuo WJ. Clinicopathological Characteristics and Survival Outcomes of Invasive Cribriform Carcinoma of Breast A SEER Population-Based Study. Medicine 2015; 31:94.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Multimorbidite |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Aralık 2024 |
| Gönderilme Tarihi | 16 Ekim 2024 |
| Kabul Tarihi | 8 Kasım 2024 |
| Yayımlandığı Sayı | Yıl 2024Cilt: 46 Sayı: 4 |
