THE IMPACT OF STAGE AND HISTOLOGY ON THE LONG-TERM CLINICAL COURSE OF163,808 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 gov erned by two components: likelihood of cure and median tumor-related s urvival time among uncured patients. Estimates of these components can be derived only by using survival models that incorporate cured fract ion as a specific parameter. METHODS. The prognostic value of stage an d histologic type was determined for 163,808 patients with breast carc inoma using the log normal and log legit cure-based survival models. F ollow-up ranged from 1 month to 19 years and was obtained from the SEE R Program. RESULTS, In approximate terms, ductal carcinoma was diagnos ed in 70% of the patients, with estimated cured fractions of 2/3 and 1 /3 for local, and regional disease, respectively. Estimates of median survival times for uncured patients were 10 and 5 years. Findings were similar for patients with tumors of miscellaneous histologic types. F or patients with medullary carcinoma, cured fractions were relatively high at 82% and 64%, but median survival times were relatively short a t 4 and 3 years. Corresponding values for patients with invasive comed o carcinoma were 82% and 50%, with median survival rimes of 6 and 4 ye ars. For patients with mucinous, lobular, and ductolobular carcinomas, parametric analysis gave inconsistent estimates of cured fraction, bu t findings suggested unusually long tumor-related survival times. CONC LUSIONS, Cure-based parametric survival models offer valuable insight into the impact of stage and histology on the clinical course of breas t cancer. (C) 1996 American Cancer Society.