Abstract #1075 Background: Screening mammography has increased the frequency of diagnosis of small (≤1 cm) invasive breast cancer (BC), for which the prognosis after locoregional therapy remains controversial. Patients and methods: We have performed a retrospective analysis of 882 patients with ≤1 cm BC and positive or negative-nodes, treated in our Institution from 1990 to 2005. Risks of axillary nodes involvement (ANI), relapse-free (RFS) and overall survival (OS) were analyzed according to: age, tumor size, histologic type and grading, ER and PgR status and MIB-1, HER-2 and p53 immuno histochemical expression. Results: Median age at diagnosis was 57 years (range: 20 - 86 years). Tumor size was: 71 Tmic (a single focus of invasive carcinoma ≤ 2 mm or up to 3 foci ≤1 mm in greatest dimensions, according to Silver and Tavassoli), 225 T1a (>2 -5 mm) and 586 T1b (>5–10 mm). ANI was found in 122 cases (13,8%): only 1 inT1mic (1,4%), 21 in T1a (9,3%) and 100 in T1b (17%). Tumor size, young age, poor differentiation and ductal histology were significantly associated with ANI (p=0.01). Local relapses were: 3 in Tmic pts(2 DCIS and 1 invasive), 13 in T1a, 22 in T1b. Distant metastases were: 1 in Tmic pts, 11 in T1a, 17 in T1b. At a median follow up of 92 months, RFS was 86,4% (Tmic: 86,8%, T1a: 86,2%; T1b: 86,2%). BC-specific mortality was 2% for T1mic, 3,3% for T1a, 3,8% for T1b accounting for an OS of 96,6%. Nodal involvement was the more relevant prognostic factor for survival, followed by young age, poor differentiation, high MIB-1 and p53. Conclusions: In pts with 1 cm or smaller Invasive Breast Carcinoma, the risk of ANI is low, but not negligible, particularly for T1b tumors. Furthermore, the prognosis of these pts is influenced by high histological grade and young age.
Invasive breast carcinoma of 1 cm or smaller: risk of nodal involvement and prognosis
Bernardi D;
2009-01-01
Abstract
Abstract #1075 Background: Screening mammography has increased the frequency of diagnosis of small (≤1 cm) invasive breast cancer (BC), for which the prognosis after locoregional therapy remains controversial. Patients and methods: We have performed a retrospective analysis of 882 patients with ≤1 cm BC and positive or negative-nodes, treated in our Institution from 1990 to 2005. Risks of axillary nodes involvement (ANI), relapse-free (RFS) and overall survival (OS) were analyzed according to: age, tumor size, histologic type and grading, ER and PgR status and MIB-1, HER-2 and p53 immuno histochemical expression. Results: Median age at diagnosis was 57 years (range: 20 - 86 years). Tumor size was: 71 Tmic (a single focus of invasive carcinoma ≤ 2 mm or up to 3 foci ≤1 mm in greatest dimensions, according to Silver and Tavassoli), 225 T1a (>2 -5 mm) and 586 T1b (>5–10 mm). ANI was found in 122 cases (13,8%): only 1 inT1mic (1,4%), 21 in T1a (9,3%) and 100 in T1b (17%). Tumor size, young age, poor differentiation and ductal histology were significantly associated with ANI (p=0.01). Local relapses were: 3 in Tmic pts(2 DCIS and 1 invasive), 13 in T1a, 22 in T1b. Distant metastases were: 1 in Tmic pts, 11 in T1a, 17 in T1b. At a median follow up of 92 months, RFS was 86,4% (Tmic: 86,8%, T1a: 86,2%; T1b: 86,2%). BC-specific mortality was 2% for T1mic, 3,3% for T1a, 3,8% for T1b accounting for an OS of 96,6%. Nodal involvement was the more relevant prognostic factor for survival, followed by young age, poor differentiation, high MIB-1 and p53. Conclusions: In pts with 1 cm or smaller Invasive Breast Carcinoma, the risk of ANI is low, but not negligible, particularly for T1b tumors. Furthermore, the prognosis of these pts is influenced by high histological grade and young age.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
