Background: Tmic is considered a separate pathologic entity with good prognosis, but its clinical significance and management remain controversial. We present our retrospective review of 69 cases of Tmic, among 6,023 BC pts (1%), observed at our institution from 1990 to 2007. Methods: We considered Tmic a single focus of invasive carcinoma ≤ 2 mm or up to 3 foci ≤ 1 mm in greatest dimensions (according to Silver and Tavassoli, Cancer 1998). Descriptive analysis of pts characteristics, treatment and clinical outcome are reported. Results: Among 69 women (mostly asymptomatic, presenting mammographic abnormalities, with median age 52, range 20–78), T≤ 1 mm in 55 pts (80%) and T≤ 2 mm in 14 (20%) were observed. Radical mastectomy was performed in 31 pts (45%) due to extended in situ component or multicentric disease, and breast conserving surgery (BCS) in 38 (55%). All pts but 4, received axillary node dissection (61 pts) or sentinel node biopsy (4 pts), with only 1 N+ pt. The “in situ” component presented ductal in 91% and lobular histology in 9% of the cases, with predominant comedo subtype in 45%. All Tmic presented ductal histology with positive hormone receptor status (HR) in 45%, negative in 22% and unknown in 33%. Among 32 HER-2 evaluable pts, HER-2 was overexpressed in 34% and normal in 66%. Adjuvant treatment consisted of radiotherapy in 87% of BCS pts, chemotherapy in 5 HR neg pts, endocrine therapy in 7 and chemo-endocrine in 1 N+ pt. At a median follow-up of 93 months RFS and BC specific OS were 91 and 100%, respectively. Three pts experienced a local relapse (2 DCIS and 1 invasive) and 1 distant metastases (bone). None of relapsed pts had received systemic adjuvant therapy. Three pts died for non-breast cancer causes. Six pts developed a controlateral BC (9%): none of them progressed or died of disease. Conclusions: Our data appear in large part comparable to those of the literature on Tmic and, in our experience, the inclusion of microinvasion > 1 mm and ≤ 2 mm did not change the good prognosis of microinvasive cancer.
Microinvasive breast cancer (Tmic): A descriptive mono-institutional report
Bernardi D;
2008-01-01
Abstract
Background: Tmic is considered a separate pathologic entity with good prognosis, but its clinical significance and management remain controversial. We present our retrospective review of 69 cases of Tmic, among 6,023 BC pts (1%), observed at our institution from 1990 to 2007. Methods: We considered Tmic a single focus of invasive carcinoma ≤ 2 mm or up to 3 foci ≤ 1 mm in greatest dimensions (according to Silver and Tavassoli, Cancer 1998). Descriptive analysis of pts characteristics, treatment and clinical outcome are reported. Results: Among 69 women (mostly asymptomatic, presenting mammographic abnormalities, with median age 52, range 20–78), T≤ 1 mm in 55 pts (80%) and T≤ 2 mm in 14 (20%) were observed. Radical mastectomy was performed in 31 pts (45%) due to extended in situ component or multicentric disease, and breast conserving surgery (BCS) in 38 (55%). All pts but 4, received axillary node dissection (61 pts) or sentinel node biopsy (4 pts), with only 1 N+ pt. The “in situ” component presented ductal in 91% and lobular histology in 9% of the cases, with predominant comedo subtype in 45%. All Tmic presented ductal histology with positive hormone receptor status (HR) in 45%, negative in 22% and unknown in 33%. Among 32 HER-2 evaluable pts, HER-2 was overexpressed in 34% and normal in 66%. Adjuvant treatment consisted of radiotherapy in 87% of BCS pts, chemotherapy in 5 HR neg pts, endocrine therapy in 7 and chemo-endocrine in 1 N+ pt. At a median follow-up of 93 months RFS and BC specific OS were 91 and 100%, respectively. Three pts experienced a local relapse (2 DCIS and 1 invasive) and 1 distant metastases (bone). None of relapsed pts had received systemic adjuvant therapy. Three pts died for non-breast cancer causes. Six pts developed a controlateral BC (9%): none of them progressed or died of disease. Conclusions: Our data appear in large part comparable to those of the literature on Tmic and, in our experience, the inclusion of microinvasion > 1 mm and ≤ 2 mm did not change the good prognosis of microinvasive cancer.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
