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Randomized Controlled Trial
. 2022 Dec;11(23):4501-4512.
doi: 10.1002/cam4.4839. Epub 2022 May 22.

Clinicopathological characteristics and prognosis of microinvasive breast cancer: A population-based analysis

Hangcheng Xu  1 , Yiqun Han  1 , Yun Wu  1 , Yan Wang  1 , Jiayu Wang  1 , Binghe Xu  1
Affiliations
Randomized Controlled Trial

Clinicopathological characteristics and prognosis of microinvasive breast cancer: A population-based analysis

Hangcheng Xu et al. Cancer Med. 2022 Dec.

Abstract

Objectives: Microinvasive breast cancer (MIBC) is a special type of breast cancer with a relatively low prevalence, of which the understanding remains controversial. In this article, we aimed to clarify the clinicopathological characteristics and prognosis of MIBC in the setting of different molecular subtypes and give feasible suggestions on clinical practice in MIBC.

Methods: This study utilized the data from Surveillance, Epidemiology, and End Results (SEER) database. Patients were divided into subgroups based on the molecular subtypes, of which the clinicopathological characteristics were further undergone comparative analyses. Kaplan-Meier method and Cox proportional hazard regression analysis were employed to determine the prognosis of the subtypes, and to explore the prognostic factors. Patients were randomly assigned in a 7:3 ratio to the training and validation cohorts. The independent risk variables were then adopted to generate a nomogram to predict the 3- and 5-year survival probability.

Results: A total of 4301 MIBC patients between 2010 and 2016 were obtained from the SEER database, which were subsequently separated into HR+/HER2- (n = 2598), HR+/HER2+ (n = 723), HR-/HER2+ (n = 633), and HR-/HER2- (n = 347) groups. The HR+/HER2+ group showed the best overall survival (OS) (81.28 months, 95% CI 80.45-82.11) compared with other groups (p = 0.0089). The application of radiotherapy in HR+/HER2- and HR+/HER2+ MIBC patients brought out additional survival benefit compared with those without radiotherapy (p < 0.0001 and p = 0.024, respectively). The prognosis among four subgroups with or without chemotherapy showed no statistical difference. Based on the curated nomogram, the high-score group exhibited a better OS compared with patients from the low-score group.

Conclusions: Profound heterogeneity was detected among different molecular subtypes in MIBC patients, of which HR+/HER2+ subtype presented the best prognosis. For HR-positive MIBC patients, increasing survival benefits could be retrieved from radiotherapy. Chemotherapy was not recommended for patients with MIBC. Individual-based protocols were introduced based on the nomogram which warranted further validation.

Keywords: breast cancer; clinical features; microinvasive carcinoma; molecular subtypes; nomogram; prognosis.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

FIGURE 1
FIGURE 1
The comparison of survival outcomes of MIBC patients among four molecular subtypes.
FIGURE 2
FIGURE 2
The comparison of survival outcomes of MIBC patients with N0/N1mi among four molecular subtypes.
FIGURE 3
FIGURE 3
Construction and validation of nomogram. (A) Nomogram for predicting 3‐ and 5‐year overall survival of MIBC patients. (B) Concordance index curves of the nomogram in training and validation cohorts. (C) Calibration curves of the nomogram for 3‐year survival probability in training and validation cohorts. (D) Calibration curves of the nomogram for 5‐year survival probability in training and validation cohorts.
FIGURE 4
FIGURE 4
Survival curves stratified by score calculated in the nomogram for MIBC patients.
See this image and copyright information in PMC

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