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  • br Fibroepithelial Tumor br mas

    2019-11-11


    Fibroepithelial Tumor 47 35.1%
    mas have had significantly worse outcomes than fibroepithelial tumors; Sarcoma 19 14.2%
    therefore, to compare high risk and low risk histologic variants of pedi- Carcinosarcoma 1 0.8%
    atric breast cancer, histology was recoded into adenocarcinoma/sar- Hormone Receptor (N = 30)
    coma and fibroepithelial tumors. A comparison between 1973–2004
    and 2005–2014 cohorts was made in order to update the descriptive
    a All ER/PR positive tumors were adenocarcinoma. analysis provided by Gutierrez et al. [1] and assess for any differences
    between these two groups.
    1.3. Statistical analysis
    Analysis was performed using Stata Statistical Software version 13.1 (StataCorp LP, College Station, TX). Associations between categorical variables were made using X2 test. Univariate survival analysis was completed using the log-rank test. Kaplan–Meier analysis was per-formed to investigate five-year survival rates across several variables. Adjusted survival analysis was performed using a Cox Proportional-Hazards regression adjusting for histology, grade, stage and race.
    2. Results
    2.1. Patient demographics
    A total of 134 pediatric patients (19 years old and younger) with breast malignancies were identified in the SEER database from 1973 to 2014. Table 1 shows that 85.2% of patients were aged 15 to 19 years old at the time of diagnosis, with a median age of 17 years old. 98.5% of patients were female. When looking at Dalbavancin variation among patients, the majority of patients were nonblack (76.1%), compared to 23.9% black patients.
    2.2. Tumor demographics
    Tumor demographics were assessed by stage, grade, histology and hormone status with results displayed in Table 2. By stage, most
    Table 1
    Demographics of pediatric breast cancer patients.
    N % of total cases
    Age at Diagnosis
    a Nonblack: white, Hispanic, other (American Indian/AK Native, Asian/Pacific Islander). 
    patients presented with early stage disease—10.8% with in situ breast cancer and 65.8% with localized breast cancer. This was in comparison to only 15.0% of patients with regional disease and 8.3% of patients with distant disease. When assessed by grade, tumors were more evenly distributed. 53.3% of patients had low grade disease (well/moderately differentiated), while 46.5% had high grade disease (poorly differenti-ated/undifferentiated). Histologically, 48.51% were carcinoma, 35.1% fibroepithelial tumors, and 14.2% sarcomas. Finally, of those tested, al-most half (46.7%) of patients had ER/PR negative tumors and 4.4% of pa-tients were found to have triple negative disease defined as ER/PR/Her2 negative tumors.
    2.3. Outcome analysis
    Among Linker fragment pediatric population, 88.9% of patients underwent sur-gery for treatment of their disease. Survival outcomes are shown in both Table 3 and Fig. 1. Among the 23.0% of patients that died in this pa-tient cohort, 71.0% died secondary to breast cancer. When analyzing deaths by histology, the majority were related to carcinoma (71.0%), followed by sarcoma (12.9%), fibroepithelial tumors (12.9%), and carci-nosarcoma (3.2%). A comparison of data before and after 2005 revealed there was a significant difference between tumor grade, with more high grade disease seen after 2005 (p = 0.038). Unadjusted five-year sur-vival analysis showed significant differences in survival by histology, grade, and stage, but not race. Adenocarcinoma/sarcoma portended worse survival when compared to fibroepithelial tumors (p b 0.001). High grade and advanced stage disease had worse outcomes than low grade and early stage disease (p b 0.001 for both). However, black and
    Table 3
    Outcomes of pediatric breast cancer.
    N % of total
    Surgery Performed 119 88.2% Surgery Not Performed 15 11.1% Mean Follow-up Time 52 months
    Mortality
    Related to Breast CA