Prognostic Analysis of Survival in Small Breast Cancers

Mustafa, Isha A.; Cole, Bernard F.; Wanebo, Harold J.; Bland, Kirby I.; Chang, Helena R.

doi:10.1016/s1072-7515(98)00076-3

Cited by 26 publications

(13 citation statements)

References 11 publications

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“…Although in our study we did not find any difference in the incidence of positive axillary nodes between the two invasive groups, the overall incidence (21%) is similar to that reported by others in association with invasive carcinomas < 10 mm. The prognostic significance of axillary nodal status is also in agreement with others who, like us, have found that this together with tumour grade is the most significant prognostic marker in small invasive carcinomas (Joensuu and Toikkanen, 1991;Arnesson et al, 1994;Mustafa et al, 1998;Querzoli et al, 1998). Some biological markers, including those used in this present study, have been shown to be preferentially expressed by certain classes of tumour, and in the case of DCIS have shown correlation with different histological types Mack et al, 1997).…”

Section: Discussionsupporting

confidence: 91%

Minimal breast cancer: evaluation of histology and biological marker expression

et al. 1999

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Ninety-eight minimal breast cancers (MBCs) diagnosed between 1975 and 1990, and all originally considered to be invasive were found, on review, to form three groups: (a) 28 predominantly invasive carcinomas ≤10 mm (‘predominant invasive’); (b) 48 predominantly ductal carcinoma in situ (DCIS) lesions with definite foci of invasion each ≤10 mm (‘predominant DCIS’); and (c) 22 DCIS without evidence of invasion (‘pure DCIS’). Tumour histology and immunohistochemical expression of Ki-67, c- erb B2, p53, oestrogen receptor (ER), progesterone receptor (PR), and Bcl-2 were compared. The major finding was the contrasting features in the two invasive groups, with significant differences in their extent of invasion ( P < 0.0001), tumour grade ( P = 0.03), DCIS type ( P = 0.008) and in marker expression. In the predominant invasive group, the infiltrative component was usually greater than 5 mm, low-grade and associated with well-differentiated DCIS. Expression of Ki-67, c- erb B2 and p53 was generally low, and that of ER, PR and Bcl-2 high. The predominant DCIS group in contrast had a much smaller, commonly high-grade, invasive component, usually with poorly differentiated DCIS and the reverse pattern of marker expression. Although not significant, survival of patients in the predominant invasive group was slightly better. These findings suggest that invasive MBCs should perhaps be treated as separate entities, in order to aid more appropriate selection of treatment. © 1999 Cancer Research Campaign

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Section: Discussionsupporting

confidence: 91%

Minimal breast cancer: evaluation of histology and biological marker expression

et al. 1999

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“…Men with tumor size from two to five cm have for 40% greater risk of death in comparison to men who have a tumor smaller than 2cm (Mustafa et al, 1998), that is five year survival of men with breast cancer smaller than 2cm is 74%, while 37% in those with a tumor greater than 5cm (Guinee et al, 1993). In our study the rate of overall five year survival of men with breast cancer in relation to tumor size is 100% for tumors ≤2cm, and 38% for tumors greater than 5cm.…”

Section: Discussionmentioning

confidence: 99%

Multivariate Analysis of Prognostic Factors in Male Breast Cancer in Serbia

Šipetić-Grujičić

Murtezani²,

Z³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: The aim of this study was to analyze the demographic and clinical characteristics of male breast cancer patients in Serbia, and furthermore to determine overall survival and predictive factors for prognosis. Materials and Methods: In the period of 1996-2006 histopathological diagnosis of breast cancer was made in 84 males at the Institute for Oncology and Radiology of Serbia. For statistical analyses the Kaplan-Meier method, long-rank test and Cox proportional hazards regression model were used. Results: The mean age at diagnosis with breast cancer was 64.3±10.5 years with a range from 35-84 years. Nearly 80% of the tumors showed ductal histology. About 44% had early tumor stages (I and II) whereas 46.4% and 9.5% of the male exhibitied stages III and IV, respectively. Only 7.1% of male patients were grade one. One-fifth of all patients had tumors measuring ≤2 cm, and 14.3% larger than 5 cm. Lymph node metastasis was recorded in 40.4% patients and 47% relapse. Estrogen and progesterone receptor expression was positive in 66.7% and 58.3%, respectively. Among 14.3% of individuals tumor was HER2 positive. About two-thirds of all male patients had radical mastectomy (66.7%). Adjuvant hormonal (tamoxifene), systematic chemotherapy (CMF or FAC) and adjuvant radiotherapy were given to 59.5%, 35.7% and 29.8% patients respectively. Overall survival rates at five and ten years for male breast cancer were 55.0% and 43.9%, respectively. According to the multivariate Cox regression predictive model, a lower initial disease stage, a lower tumor grade, application of adjuvant hormone therapy and no relapse occurrence were significant independent predictors for good overall survival. Conclusions: Results of the treatment would be better if disease is discovered earlier and therefore health education and screening are an imperative in solving this problem.

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“…The rationales for ALND are the exact staging and prognosis, the regional control in the axilla and the possibility of survival improvement (Fisher et al, 1980;Harris and Osteen, 1985;Petrek and Blackwood, 1995). The extent of the axillary lymph node involvement is one of the most important independent prognostic factors for recurrence and survival in patients with invasive breast cancer (Carter et al, 1989;Rosen et al, 1989Rosen et al, , 1993Rosen and Groshen, 1990;NIH Consensus Conference, 1991;Mustafa et al, 1998). However, ALND is associated with major problems such as pain, restriction of arm motion or chronic lymphedema.…”

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confidence: 99%

200 Sentinel lymph node biopsies without axillary lymph node dissection – no axillary recurrences after a 3-year follow-up

Reitsamer

Peintinger²,

Prokop

et al. 2004

Br J Cancer

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The aim of this study is to evaluate the rate of axillary recurrences in sentinel lymph node (SLN)-negative breast cancer patients after sentinel lymph node biopsy (SLNB) alone without further axillary lymph node dissection (ALND). Between May 1999 and February 2002, 333 consecutive patients with primary invasive breast cancer up to 4 cm and clinically negative axillae were entered into this prospective study. Sentinel lymph nodes were identified using the combined method with blue dye (Patent blue V s ) and technetium 99m-labelled albumin (Nanocoll s ). Sentinel lymph nodes were examined by frozen sections, standard haematoxylin and eosin staining and immunohistochemistry staining. In SLN-positive patients, ALND was performed. Sentinel lymph node-negative patients had no further ALND. The SLN identification rate was 98.5% (328 out of 333). In all, 128 out of 328 (39.0%) patients had positive SLNs and complete ALND. A total of 200 out of 328 (61.0%) patients were SLN negative and had no further ALND. The mean tumour size of SLN-negative patients was 16.5 mm. The mean number of SLNs removed was 2.1 per patient. There were no local or axillary recurrences at a median follow-up of 36 months. The absence of axillary recurrences after SLNB without ALND in SLNnegative breast cancer patients supports the hypothesis that SLNB is accurate and safe while providing less surgical morbidity than ALND. Short-term results are very promising that SLNB without ALND in SLN-negative patients is an excellent procedure for axillary staging in a cohort of breast cancer patients with small tumours.

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Prognostic Analysis of Survival in Small Breast Cancers

Cited by 26 publications

References 11 publications

Minimal breast cancer: evaluation of histology and biological marker expression

Minimal breast cancer: evaluation of histology and biological marker expression

Multivariate Analysis of Prognostic Factors in Male Breast Cancer in Serbia

200 Sentinel lymph node biopsies without axillary lymph node dissection – no axillary recurrences after a 3-year follow-up

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