Prognostic Features and Predictive Model for Mixed Invasive Ductal and Lobular Breast Carcinoma in Early-Stage Patients.

IF 2.9 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2025-04-01 DOI:10.1016/j.clbc.2025.03.019

Yongxin Li, Yinyin Ye, Xinlong Tao, Xiao Liang, Xingchang Qiu, Jiuda Zhao

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引用次数: 0

Abstract

Introduction: Mixed invasive ductal and lobular breast carcinoma (IDLC) is a rare and understudied subtype of breast cancer with unique prognostic characteristics.

Methods: This study analyzed data from the SEER database and the METABRIC database. Survival outcomes of IDLC were compared with those of IDC and ILC using Kaplan-Meier survival curves and Cox regression analyses. Based on these findings, a prognostic model tailored for IDLC patients was developed using the SEER cohort, which was divided into a training set (70%) and an internal validation set (30%). The model incorporated clinical and molecular features and was externally validated using the METABRIC cohort. Its performance was assessed via C-index, AUC, calibration curves, and decision curve analysis (DCA).

Results: A total of 26,138 early-stage IDLC patients were included, along with 391,888 IDC and 47,571 ILC patients. In unadjusted analyses, IDLC showed better overall survival (OS) and breast cancer-specific survival (BCSS) compared to both IDC and ILC. However, after multivariate adjustment, the differences in survival outcomes varied. IDLC demonstrated better OS than IDC and better BCSS than ILC. Additionally, a prognostic model for early-stage IDLC that incorporates clinical and molecular features was developed.

Conclusion: This study found that early-stage IDLC had superior BCSS and OS in unadjusted analyses. However, after multivariate adjustment, there was no difference in BCSS between IDLC and IDC, and no difference in OS between IDLC and ILC. A prognostic model was developed and validated, offering precise predictions of OS and BCSS.

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早期浸润性导管、小叶混合性乳腺癌的预后特点及预测模型。

摘要：混合性浸润性导管和小叶乳腺癌（IDLC）是一种罕见的乳腺癌亚型，具有独特的预后特征。方法：本研究分析来自SEER数据库和METABRIC数据库的数据。采用Kaplan-Meier生存曲线和Cox回归分析比较IDLC与IDC和ILC的生存结局。基于这些发现，使用SEER队列开发了适合IDLC患者的预后模型，该队列分为训练集（70%）和内部验证集（30%）。该模型结合了临床和分子特征，并使用METABRIC队列进行了外部验证。通过c指数、AUC、校准曲线和决策曲线分析（DCA）对其性能进行评价。结果：共纳入26138例早期IDLC患者，391,888例IDC患者和47,571例ILC患者。在未经调整的分析中，与IDC和ILC相比，IDLC显示出更好的总生存期（OS）和乳腺癌特异性生存期（BCSS）。然而，在多变量调整后，生存结果的差异有所不同。IDLC表现出比IDC更好的OS，比ILC更好的BCSS。此外，我们还开发了一种结合临床和分子特征的早期IDLC预后模型。结论：本研究发现早期IDLC在未经调整的分析中具有优越的BCSS和OS。但经多因素调整后，IDLC与IDC患者的BCSS无差异，IDLC与ILC患者的OS无差异。建立并验证了预后模型，提供了OS和BCSS的精确预测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.