Intracystic papillary carcinoma of the breast: A SEER database analysis of implications for therapy

Breast. 2016 Jun:27:87-92. doi: 10.1016/j.breast.2016.01.003. Epub 2016 Apr 4.

Abstract

Background: Intracystic papillary carcinoma (IPC) of the breast is a rare breast malignancy with an indolent course. However, patients can develop metastatic disease. Indications for surgery and radiotherapeutic management have not been well elucidated.

Methods: We identified 2649 female patients with IPC from the Surveillance, Epidemiology, and End Results (SEER) registry. Differences in demographics, clinical features and survival of patients were assessed using the Kaplan-Meier method and Cox regression.

Results: Median age was 67 years. The majority of patients were white with Stage 0 disease. Most patients had lymph node evaluation and only 34% received radiation therapy. Using a log-rank test, survival was significantly better in Caucasian compared to African-American patients, patients with early stage disease, negative lymph nodes and those who received radiation (all p < 0.0001). In a Cox regression survival model adjusting for age, stage and grade, patients who were African-American (hazard ratio [HR] 2.0, CI 1.4-2.8; p < 0.0001) had a significantly higher risk of death than Caucasians. Patients who received radiation therapy (HR 0.5, CI 0.3-0.7; p = 0.0003) had a lower chance of death than patients that did not undergo radiation.

Conclusion: Overall, IPC has a good prognosis. Survival is improved in Caucasian patients and in patients who receive radiation therapy. Radiation therapy should be offered to women with IPC who undergo breast conserving surgery.

Keywords: Breast cancer; Intracystic papillary carcinoma; SEER.

MeSH terms

  • Aged
  • Black or African American / statistics & numerical data
  • Breast Neoplasms / mortality*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / therapy
  • Carcinoma, Papillary / mortality*
  • Carcinoma, Papillary / pathology
  • Carcinoma, Papillary / therapy
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lymph Node Excision
  • Mastectomy, Segmental
  • Proportional Hazards Models
  • Radiotherapy / mortality
  • SEER Program
  • White People / statistics & numerical data