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Characteristics and prognosis of 17 special histologic subtypes of invasive breast cancers according to World Health Organization classification: comparative analysis to invasive carcinoma of no special type

  • Epidemiology
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Abstract

Background

Breast cancer is a heterogeneous disease with various histopathologic subtypes. Except for invasive carcinoma of no special type (NST), other subtypes are rare with limited data. The purpose of this study was to analyze the characteristics and prognosis of special histopathologic subtypes of breast cancer compared to NST.

Methods

A total of 136,140 patients were analyzed using the Korean Breast Cancer Society Registry database between January 1996 and March 2019. The clinicopathologic features and survival outcomes of special type breast carcinoma were compared with those of NST.

Results

The prevalence of special subtypes other than NST was 13.7% (n = 18,633). Compared to NST, patients with lobular, medullary, metaplastic, and micropapillary carcinoma had larger tumors (p < 0.001). Patients with mucinous, tubular, medullary, metaplastic, and cribriform carcinoma presented with less node metastasis (p < 0.001), contrary to patients with micropapillary carcinoma. Patients with lobular, mucinous, tubular, papillary, and cribriform carcinoma presented as luminal A subtype much more often (p < 0.001). Micropapillary carcinoma included more luminal B subtype (p < 0.001). Typically, medullary and metaplastic carcinoma included more triple-negative subtypes (p < 0.001). In survival analysis, only medullary (Hazard Ratio (HzR) 0.542, 95% CI 0.345 to 0.852, p = 0.008) and metaplastic carcinoma (HzR 1.655, 95% CI 1.317 to 2.080, p < 0.001) showed significantly different overall survival from NST by multivariate analysis.

Conclusion

Breast cancer had distinct clinicopathologic features according to histopathologic subtype. However, special types of breast cancer had similar survival outcomes compared to NST when adjusting for other prognostic factors, except for metaplastic carcinoma and medullary carcinoma.

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Acknowledgements

This article was supported by the Korean Breast Cancer Society.

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Authors and Affiliations

  1. Department of Surgery, Daerim St. Mary’s Hospital, Seoul, South Korea

    Jiyoung Kim

  2. Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea

    Jee Ye Kim

  3. Department of Surgery, Seoul National University College of Medicine, Biomedical Research Institute, Seoul National University Hospital, Seoul, South Korea

    Han-Byoel Lee

  4. Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea

    Young Joo Lee

  5. Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea

    Min-Ki Seong

  6. Ewha Womans University Cancer Center Hospital for Women, Seoul, South Korea

    Namsun Paik

  7. Department of Surgery, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, South Korea

    Woo-Chan Park

  8. Department of Breast Surgery, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju-si, Republic of Korea

    Sungmin Park

  9. Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, 02841, Seoul, Republic of Korea

    Seung Pil Jung & Soo Youn Bae

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Kim, J., Kim, J.Y., Lee, HB. et al. Characteristics and prognosis of 17 special histologic subtypes of invasive breast cancers according to World Health Organization classification: comparative analysis to invasive carcinoma of no special type. Breast Cancer Res Treat 184, 527–542 (2020). https://doi.org/10.1007/s10549-020-05861-6

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