The impact of stage and histology on the long-term clinical course of 163,808 patients with breast carcinoma.
BACKGROUND
Stage and histologic type have a significant impact on the long term clinical course of breast carcinoma. Clinical course is governed by two components: likelihood of cure and medial tumor-related survival time among uncured patients. Estimates of these components can be derived only by using survival models that incorporate cured fraction as a specific parameter.


METHODS
The prognostic value of stage and histologic type was determined for 163,808 patients with breast carcinoma using the log normal and log logit cure-based survival models. Follow-up ranged from 1 month to 19 years and was obtained from the SEER Program.


RESULTS
In approximate terms, ductal carcinoma was diagnosed in 70% of the patients, with estimate cured fractions of 2/3 and 1/3 for local and regional disease, respectively. Estimates of medial survival times for uncured patients were 10 and 5 years. Findings were similar for patients with tumor of miscellaneous histologic types. For patients with medullary carcinoma were 82% and 50%, with median survival times of 6 and 4 years. For patients with mucinous, lobular, and ductolobular carcinomas, parametric analysis gave inconsistent estimates of cured fraction, but findings suggested unusually long tumor-related survival times.


CONCLUSIONS
Cured-based parametric survival models offer valuable insight into the impact of stage and histology on the clinical course of breast cancer.
Gamel
J W
JW
Veterans Administration Medical Center, Louisville, Kentucky, USA.
Meyer
J S
JS
Feuer
E
E
Miller
B A
BA
D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000401:mortality* / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D009367:Neoplasm Staging; D011379:Prognosis; D018426:SEER Program; D016019:Survival Analysis