Histology is an important predictor of the behavior of breast cancer. We aim to study the impact of histology on the overall survival (OS) of breast cancer patients. We studied 11,085 breast cancer patients diagnosed with T1–T2 tumors, clinically node-negative and non-metastatic, from 2004 to 2019 included in the National Cancer Database. Kaplan–Meier curves, log-rank tests and Cox regression models were used to study the impact of histology and other variables on OS. In our patient population, 8678 (78.28%) had ductal cancer (IDC), while 2407 (21.71%) had lobular cancer (ILC). ILC patients were significantly more likely to be older, Caucasian, have a lower grade at diagnosis and be hormone receptor-positive compared to IDC patients. There was no statistically significant difference in the 5-year OS of early stage ductal (16.8%) and lobular cancer patients (16.7%) (p= 0.200). Patients of Hispanic and African American origin had worse OS rates compared to non-Hispanic and Caucasian patients, respectively. For node-positive disease, HER2+ tumors and triple-negative tumors, chemotherapy had a positive influence on OS (HR 0.85, 95% CI 0.77–0.93,p= 0.0012). Histology did not have a significant impact on the 5-year OS of early stage breast cancer patients.
组织学是预测乳腺癌生物学行为的重要指标。本研究旨在探讨组织学类型对乳腺癌患者总生存期的影响。我们分析了2004年至2019年间美国国家癌症数据库中收录的11,085例T1-T2期、临床淋巴结阴性且无远处转移的乳腺癌患者。采用Kaplan-Meier曲线、时序检验和Cox回归模型分析组织学类型及其他变量对总生存期的影响。研究队列中，8678例（78.28%）为导管癌，2407例（21.71%）为小叶癌。与导管癌患者相比，小叶癌患者具有年龄更大、白种人比例更高、诊断时组织学分级更低、激素受体阳性率更高等特征。早期导管癌（16.8%）与小叶癌（16.7%）患者的5年总生存率无统计学差异（p=0.200）。西班牙裔和非裔美国患者的生存率分别低于非西班牙裔和白种人患者。对于淋巴结阳性、HER2阳性及三阴性乳腺癌患者，化疗可显著改善总生存期（风险比0.85，95%置信区间0.77-0.93，p=0.0012）。组织学类型对早期乳腺癌患者的5年总生存率无显著影响。
肿瘤(癌症)患者之家