Early stages of clear cell (glycogen rich cell) invasive ductal carcinoma (IDC) of the breast: Good or bad prognosis?

Abstract

e11053 Background: The presence of clear cells (glycogen rich cells) in invasive ductal carcinoma of the breast is infrequent. The main objective of the present paper is to analyze the frequency of this tumor subtype in our patient group. Methods: A search of the IOHM breast cancer tumors registry was carried out. In this database all 1680 tumors were reviewed by two pathologists and classified according to the USA Association of Directors of Anatomic and Surgical Pathology’s recommendations. The entire cohort was diagnosed, treated and followed at the IOHM. Only those with early stages of clear cell (glycogen rich cell) invasive ductal carcinoma of the breast were included in this paper. Results: Between January 1998 and June 2008, 945 patients with IDC and early breast cancer were identified. 17 (1,8%) of those cases presented clear cell carcinomas, and are the subject of this report. Population Characteristics: Median Age 60 years (35-88); Menopause YES/NO 11/6; High Tumor Grade 15; Predictive Factors: ER (+):=15/17, PR (+)= 13/17, Her2 (+) 2/6 (Undetermined 11 cases), Diagnosis Stage (I=6 pts, II=5 pts, III=6 pts); Surgery: Mastectomy= 3 pts, Tumorectomy= 14pts, Radiotherapy=16 pts, Adjuvant treatment: 17 pts (Only Hormonotherapy: 7 pts, Only Chemotherapy: 5 pts, Chemotherapy and hormonotherapy: 5 pts) With a median Follow Up of 97 months (27-146), twelve patients are alive and free of disease (Stage I: 6 pts, Stage II : 4 pts, Stage III: 2 pts), Four patients have recurred (Stage II: 1 pt, Stage III: 3 pts) and four have died : 3 due to the tumor and 1 due to other causes, with a global median survival of 92 months (range 16-146). In each stage, the median survival is Stage I: 86 months (44-145), Stage II: 114 months (30-129), Stage III: 69 months (16-106). Conclusions: 1) In this cohort 1.8% of patients with early IDC breast cancer possess clear cells associated with the tumor. 2) Although the number of patients is low, the evolution was better than that observed in patients with High Tumor Grade IDC at similar stages. 3) It appears that the presence of glycogen rich cells is not a factor leading to a bad prognosis.