Published online Jan 19, 2024. doi: 10.5498/wjp.v14.i1.76
Peer-review started: November 20, 2023
First decision: December 5, 2023
Revised: December 20, 2023
Accepted: December 25, 2023
Article in press: December 25, 2023
Published online: January 19, 2024
Occult breast cancer (OBC) is a rare breast disease. With atypical clinical manifestations, OBC usually presents with painless axillary masses initially, but a few patients seek medical help for neck masses.
Although it is generally accepted that OBC has a similar biological behavior to lymph node-positive non-OBC, the clinicopathological features of the disease are unclear.
This study aims at better reveal the clinicopathological features and prognostic factors of OBC patients through a retrospective analysis of their clinicopathological data.
The clinicopathological data of 33 diagnosed OBC patients were retrospectively analyzed. The psychological status of OBC patients was evaluated by self-rating Anxiety Scale and self-rating Depression Scale. Patients’ emotions, stress perception and psychological resilience were evaluated by the Positive and Negative Affect Schedule, the Chinese Perceived Stress Scale, and the Connor-Davidson Resilience Scale, respectively. Patient survival was calculated. Univariate and multivariate survival analyses were performed using the COX regression model.
There were 30 (91%) with axillary tumor and 3 (9%) with Neck mass as the first symptom; 18 (54.5%) were ER-positive, 17 (51.5%) were PR-positive, and 18 (54.5%) were Her-2-positive; 24 (72.7%) received surgical treatment, including 18 cases of modified radical mastectomy, 1 case of breast-conserving surgery plus axillary lymph node dissection (ALND), and 5 cases of ALND alone; 12 cases received preoperative neoadjuvant therapy. All the 30 patients developed certain anxiety and depression, with low positive affect scores and high negative affect scores, accompanied by a high stress level and poor psychological resilience. The overall survival and disease-free survival of all the patients was 83.3% and 55.7%, respectively. Multivariate analysis revealed that radiotherapy was an independent prognostic factor.
OBC is a rare breast disease whose diagnosis and treatment are currently controversial. There was no significant difference in the efficacy of other less invasive surgical procedures compared to the modified radical mastectomy, and radiotherapy can significantly improve patient outcomes.
The incidence of OBC is low and the diagnosis is difficult, which is easy to be ignored in clinical practice. In order to improve the quality of life of patients, appropriate treatment methods should be selected. At the same time, psychological problems also need to be concerned about.