Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jan 19, 2024; 14(1): 76-87
Published online Jan 19, 2024. doi: 10.5498/wjp.v14.i1.76
Clinicopathological features, psychological status, and prognosis of 33 patients with occult breast cancer
Hong-Mei Wang, Ao-Yang Yu, Lin-Lin Li, Lu-Yao Ma, Meng-Han Cao, Yu-Le Yang, Xiao-Bing Qin, Juan-Juan Tang, Zheng-Xiang Han
Hong-Mei Wang, Meng-Han Cao, Xiao-Bing Qin, Juan-Juan Tang, Zheng-Xiang Han, Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
Ao-Yang Yu, Lu-Yao Ma, Yu-Le Yang, Graduate School, Xuzhou Medical University, Xuzhou 221004, Jiangsu Province, China
Lin-Lin Li, Department of Pathology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221000, Jiangsu Province, China
Author contributions: Wang HM, Yu AY and Li LL contributed equally to this work and are co-first authors; Wang HM and Yu AY contributed to the research design and paper writing; Li LL, Ma LY, Cao MH, Yang YL, Qin XB and Tang JJ collected and analyzed the data; Wang HM and Han ZX overall supervise the study; and all authors contributed to the article and approved the submitted version.
Supported by Jiangsu Provincial Health Commission’s 2020 High-Level Health Talents “Six Ones Project” Top-Notch Talent Research Project, No. LGY2020006; and 2021 Youth Medical Science Innovation Project of Xuzhou Health Commission, No. XWKYHT20210580.
Institutional review board statement: The study was reviewed and approved by The Affiliated Hospital of Xuzhou Medical University (Approval No. XYFY2022-KL321-01).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zheng-Xiang Han, MD, Professor, Department of Oncology, The Affiliated Hospital of Xuzhou Medical University, No. 99 Huaihai West Road, Quanshan District, Xuzhou 221000, Jiangsu, China. cnhzxyq@163.com
Received: November 20, 2023
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
Processing time: 60 Days and 4 Hours
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

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.

Research objectives

This study aims at better reveal the clinicopathological features and prognostic factors of OBC patients through a retrospective analysis of their clinicopathological data.

Research methods

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.

Research results

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.

Research conclusions

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.

Research perspectives

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.