Survival outcomes by molecular subtypes based on receptor status in medullary breast carcinoma: a SEER database analysis

Transl Cancer Res. 2026 Mar 31;15(3):154. doi: 10.21037/tcr-2025-1-2666. Epub 2026 Feb 26.

ABSTRACT

BACKGROUND: Medullary breast carcinoma (MBC) is a rare histological subtype of invasive breast cancer. This study aimed to compare prognostic outcomes between MBC and invasive breast carcinoma of no special type (IBC-NST; the most prevalent histological category), and to further evaluate survival differences among molecular subtypes of MBC.

METHODS: Clinical and survival data for patients with MBC and IBC-NST were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was used to reduce confounding effects. Survival comparisons were performed using the log-rank test. MBC cases were categorized into triple-negative breast cancer (TNBC), luminal, and human epidermal growth factor receptor 2 (HER2)-overexpressing subtypes based on receptor status. Prognostic variations among these molecular subgroups were similarly analyzed. Cox regression was employed to identify independent prognostic factors in MBC.

RESULTS: Compared to IBC-NST patients, those with MBC were generally younger, had higher tumor grade, larger tumor size (predominantly T2 stage), higher frequency of estrogen receptor (ER)/progesterone receptor (PR)/HER2 negativity, and lower lymph node involvement. Both before and after PSM, MBC patients exhibited significantly better overall survival (OS) and breast cancer-specific survival (BCSS) than IBC-NST patients. Multivariate analysis identified age, tumor (T) stage, node (N) stage, and chemotherapy as independent prognostic factors for MBC. However, no significant survival differences were observed among molecular subtypes of MBC.

CONCLUSIONS: Despite presenting with more aggressive clinicopathological characteristics, MBC patients had a more favorable prognosis compared to those with IBC-NST. Molecular subtype was not associated with significant survival differences in MBC. Key determinants of survival in MBC included age, T stage, N stage, and chemotherapy.

PMID:41969472 | PMC:PMC13066987 | DOI:10.21037/tcr-2025-1-2666