Recurrence risk in small, node-negative, early breast cancer: A multicenter retrospective analysis

T. Gamucci, A. Vaccaro, F. Ciancola, L. Pizzuti, I. Sperduti, L. Moscetti, F. Longo, M. A. Fabbri, M. A. Giampaolo, L. Mentuccia, L. Di Lauro, P. Vici

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Abstract

Purpose: Recurrences and deaths are known to occur, even if less frequently, in small, node-negative breast cancer patients, and decision on adjuvant treatments remains controversial. In the present analysis, we evaluate recurrence risk in patients with pT1 a, b, c, node-negative, breast cancer, accordingly with some prognostic biological factors. Methods: We retrospectively evaluated 900 node-negative patients (pT1a, b, c) surgery treated between 2000 and 2009 in four Italian oncologic centers. We defined 3 different cohorts: ER positive (ER+); Her-2 positive (Her-2+); and triple negative (TN). Results: pT1a was seen in 7.6% of patients, 37.7 % pT1b, 54.8 % pT1c. Concerning the 3 different cohorts, 58.2 % were ER+; 10.8 % were Her-2+; 8.2 % were TN. Overall, chemotherapy was given to 3.0 %, 27.2 %, 69.8 % of pT1a, b, c, respectively, and to 22.7 %, 58.8 %, 68.9 % of ER+, Her-2+, TN subgroups. At a median follow-up of 67 months, 5-year DFS was 96.3 %, 89.2 %, 89.4 % in pT1a, b, c, respectively (100 %, 93.6 %, 89.8 % in ER+; 100 %, 78.7 %, 85.0 % in Her-2+; 100 %, 76.8 %, 85.2 % in TN) (p = ns). At multivariate analysis, histologic grade and Ki-67 resulted independent prognostic factors. Overall, 5-year OS was 98 %, without differences among pT1a, b, c, or among the 3 cohorts. Conclusions: Overall, 5-year DFS was very favorable in this series of small, node-negative breast cancers, but Her-2+ and TN cohorts have a higher recurrence rate than ER+ cohort (p <0.0001); pT1c, but also pT1b, in Her-2+ and TN subgroups, have a worse outcome, and effective chemotherapy treatment should be considered in these unfavorable subgroups.

Original languageEnglish
Pages (from-to)853-860
Number of pages8
JournalJournal of Cancer Research and Clinical Oncology
Volume139
Issue number5
DOIs
Publication statusPublished - May 2013

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Breast Neoplasms
Recurrence
Drug Therapy
Biological Factors
Multivariate Analysis
Therapeutics

Keywords

  • Node-negative
  • Prognostic biological factors
  • Recurrence risk
  • Small breast cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Recurrence risk in small, node-negative, early breast cancer : A multicenter retrospective analysis. / Gamucci, T.; Vaccaro, A.; Ciancola, F.; Pizzuti, L.; Sperduti, I.; Moscetti, L.; Longo, F.; Fabbri, M. A.; Giampaolo, M. A.; Mentuccia, L.; Di Lauro, L.; Vici, P.

In: Journal of Cancer Research and Clinical Oncology, Vol. 139, No. 5, 05.2013, p. 853-860.

Research output: Contribution to journalArticle

Gamucci, T, Vaccaro, A, Ciancola, F, Pizzuti, L, Sperduti, I, Moscetti, L, Longo, F, Fabbri, MA, Giampaolo, MA, Mentuccia, L, Di Lauro, L & Vici, P 2013, 'Recurrence risk in small, node-negative, early breast cancer: A multicenter retrospective analysis', Journal of Cancer Research and Clinical Oncology, vol. 139, no. 5, pp. 853-860. https://doi.org/10.1007/s00432-013-1388-2
Gamucci, T. ; Vaccaro, A. ; Ciancola, F. ; Pizzuti, L. ; Sperduti, I. ; Moscetti, L. ; Longo, F. ; Fabbri, M. A. ; Giampaolo, M. A. ; Mentuccia, L. ; Di Lauro, L. ; Vici, P. / Recurrence risk in small, node-negative, early breast cancer : A multicenter retrospective analysis. In: Journal of Cancer Research and Clinical Oncology. 2013 ; Vol. 139, No. 5. pp. 853-860.
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title = "Recurrence risk in small, node-negative, early breast cancer: A multicenter retrospective analysis",
abstract = "Purpose: Recurrences and deaths are known to occur, even if less frequently, in small, node-negative breast cancer patients, and decision on adjuvant treatments remains controversial. In the present analysis, we evaluate recurrence risk in patients with pT1 a, b, c, node-negative, breast cancer, accordingly with some prognostic biological factors. Methods: We retrospectively evaluated 900 node-negative patients (pT1a, b, c) surgery treated between 2000 and 2009 in four Italian oncologic centers. We defined 3 different cohorts: ER positive (ER+); Her-2 positive (Her-2+); and triple negative (TN). Results: pT1a was seen in 7.6{\%} of patients, 37.7 {\%} pT1b, 54.8 {\%} pT1c. Concerning the 3 different cohorts, 58.2 {\%} were ER+; 10.8 {\%} were Her-2+; 8.2 {\%} were TN. Overall, chemotherapy was given to 3.0 {\%}, 27.2 {\%}, 69.8 {\%} of pT1a, b, c, respectively, and to 22.7 {\%}, 58.8 {\%}, 68.9 {\%} of ER+, Her-2+, TN subgroups. At a median follow-up of 67 months, 5-year DFS was 96.3 {\%}, 89.2 {\%}, 89.4 {\%} in pT1a, b, c, respectively (100 {\%}, 93.6 {\%}, 89.8 {\%} in ER+; 100 {\%}, 78.7 {\%}, 85.0 {\%} in Her-2+; 100 {\%}, 76.8 {\%}, 85.2 {\%} in TN) (p = ns). At multivariate analysis, histologic grade and Ki-67 resulted independent prognostic factors. Overall, 5-year OS was 98 {\%}, without differences among pT1a, b, c, or among the 3 cohorts. Conclusions: Overall, 5-year DFS was very favorable in this series of small, node-negative breast cancers, but Her-2+ and TN cohorts have a higher recurrence rate than ER+ cohort (p <0.0001); pT1c, but also pT1b, in Her-2+ and TN subgroups, have a worse outcome, and effective chemotherapy treatment should be considered in these unfavorable subgroups.",
keywords = "Node-negative, Prognostic biological factors, Recurrence risk, Small breast cancer",
author = "T. Gamucci and A. Vaccaro and F. Ciancola and L. Pizzuti and I. Sperduti and L. Moscetti and F. Longo and Fabbri, {M. A.} and Giampaolo, {M. A.} and L. Mentuccia and {Di Lauro}, L. and P. Vici",
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T1 - Recurrence risk in small, node-negative, early breast cancer

T2 - A multicenter retrospective analysis

AU - Gamucci, T.

AU - Vaccaro, A.

AU - Ciancola, F.

AU - Pizzuti, L.

AU - Sperduti, I.

AU - Moscetti, L.

AU - Longo, F.

AU - Fabbri, M. A.

AU - Giampaolo, M. A.

AU - Mentuccia, L.

AU - Di Lauro, L.

AU - Vici, P.

PY - 2013/5

Y1 - 2013/5

N2 - Purpose: Recurrences and deaths are known to occur, even if less frequently, in small, node-negative breast cancer patients, and decision on adjuvant treatments remains controversial. In the present analysis, we evaluate recurrence risk in patients with pT1 a, b, c, node-negative, breast cancer, accordingly with some prognostic biological factors. Methods: We retrospectively evaluated 900 node-negative patients (pT1a, b, c) surgery treated between 2000 and 2009 in four Italian oncologic centers. We defined 3 different cohorts: ER positive (ER+); Her-2 positive (Her-2+); and triple negative (TN). Results: pT1a was seen in 7.6% of patients, 37.7 % pT1b, 54.8 % pT1c. Concerning the 3 different cohorts, 58.2 % were ER+; 10.8 % were Her-2+; 8.2 % were TN. Overall, chemotherapy was given to 3.0 %, 27.2 %, 69.8 % of pT1a, b, c, respectively, and to 22.7 %, 58.8 %, 68.9 % of ER+, Her-2+, TN subgroups. At a median follow-up of 67 months, 5-year DFS was 96.3 %, 89.2 %, 89.4 % in pT1a, b, c, respectively (100 %, 93.6 %, 89.8 % in ER+; 100 %, 78.7 %, 85.0 % in Her-2+; 100 %, 76.8 %, 85.2 % in TN) (p = ns). At multivariate analysis, histologic grade and Ki-67 resulted independent prognostic factors. Overall, 5-year OS was 98 %, without differences among pT1a, b, c, or among the 3 cohorts. Conclusions: Overall, 5-year DFS was very favorable in this series of small, node-negative breast cancers, but Her-2+ and TN cohorts have a higher recurrence rate than ER+ cohort (p <0.0001); pT1c, but also pT1b, in Her-2+ and TN subgroups, have a worse outcome, and effective chemotherapy treatment should be considered in these unfavorable subgroups.

AB - Purpose: Recurrences and deaths are known to occur, even if less frequently, in small, node-negative breast cancer patients, and decision on adjuvant treatments remains controversial. In the present analysis, we evaluate recurrence risk in patients with pT1 a, b, c, node-negative, breast cancer, accordingly with some prognostic biological factors. Methods: We retrospectively evaluated 900 node-negative patients (pT1a, b, c) surgery treated between 2000 and 2009 in four Italian oncologic centers. We defined 3 different cohorts: ER positive (ER+); Her-2 positive (Her-2+); and triple negative (TN). Results: pT1a was seen in 7.6% of patients, 37.7 % pT1b, 54.8 % pT1c. Concerning the 3 different cohorts, 58.2 % were ER+; 10.8 % were Her-2+; 8.2 % were TN. Overall, chemotherapy was given to 3.0 %, 27.2 %, 69.8 % of pT1a, b, c, respectively, and to 22.7 %, 58.8 %, 68.9 % of ER+, Her-2+, TN subgroups. At a median follow-up of 67 months, 5-year DFS was 96.3 %, 89.2 %, 89.4 % in pT1a, b, c, respectively (100 %, 93.6 %, 89.8 % in ER+; 100 %, 78.7 %, 85.0 % in Her-2+; 100 %, 76.8 %, 85.2 % in TN) (p = ns). At multivariate analysis, histologic grade and Ki-67 resulted independent prognostic factors. Overall, 5-year OS was 98 %, without differences among pT1a, b, c, or among the 3 cohorts. Conclusions: Overall, 5-year DFS was very favorable in this series of small, node-negative breast cancers, but Her-2+ and TN cohorts have a higher recurrence rate than ER+ cohort (p <0.0001); pT1c, but also pT1b, in Her-2+ and TN subgroups, have a worse outcome, and effective chemotherapy treatment should be considered in these unfavorable subgroups.

KW - Node-negative

KW - Prognostic biological factors

KW - Recurrence risk

KW - Small breast cancer

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