Small breast cancers: When and how to treat

Tryfonidis, Konstantinos; Zardavas, Dimitrios; Cardoso, Fátima

doi:10.1016/j.ctrv.2014.09.004

Cited by 14 publications

(7 citation statements)

References 70 publications

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“…The incidence of T1mi,a,b (≤10 mm) tumors has increased over the past 20 years, partly due to the implementation of screening mammography. Today, these small breast cancer comprise half of newly diagnosed stage I breast cancers every year …”

Section: Introductionmentioning

confidence: 99%

Outcomes in patients with small node‐negative invasive breast cancer

et al. 2019

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Purpose There is controversy whether systemic therapy is warranted in patients with small node‐negative tumors, especially among those with HER2+ and triple negative breast cancers (TNBC). In this study we sought to compare survival and recurrence rates (RR) in patients with T1mi,a,bN0M0 breast cancer by tumor type. Methods Review of a prospectively maintained data base between January 1, 2000 through December 31, 2013 identified 71 patients with HER2+ tumors, 545 with hormone receptor (HR)+/HER2− tumors, and 45 with TNBC. The three groups were compared with respect to RR, disease‐free survival (DFS), and overall survival (OS). Patients with HER2+ disease and TNBC who received chemotherapy were compared to those who did not. Results At mean follow‐up of 4.9 years, the 5‐year OS was 95% and 5‐year DFS was 98%. RR for HER2+, HR+/HER2−, and TNBC was 7.0%, 3.7%, and 4.4% respectively (P = 0.2). There was no significant difference in OS (P = 0.9) and DFS (P = 0.4) amongst the three groups. On multivariable analysis, use of adjuvant chemotherapy was not associated with improvement in DFS or OS. When patients with HER2+ breast cancer and TNBC who received chemotherapy were compared to those who did not, there was no difference in death rates (P = 0.3). Conclusions Patients with T1mi,a,bN0M0 invasive breast cancer have an excellent prognosis. The three molecular subtypes differed significantly in age, tumor size, and tumor grade, but had similar RR, DFS, and OS. Chemotherapy was not associated with improved survival. Tumor subtype may not influence recurrence and survival in such small early stage tumors.

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Section: Introductionmentioning

confidence: 99%

Outcomes in patients with small node‐negative invasive breast cancer

et al. 2019

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“…The rationale behind this is that treatment recommendations generally do not consider ER-status in Her2 + BC. [21,22] In our cohort, most (17/26) Her2 + tumours were ER+, but the BC deaths and the distant recurrences all occurred in the Her2+/ER-subgroup, while locoregional recurrences occurred equally in the Her2+/ER-and Her2+/ER + groups. Furthermore, there are retrospective studies showing a bene t only of endocrine therapy alone (for Her2+/ER + tumours) but not chemotherapy with/without trastuzumab, for women with Her2-positive pT1abN0 tumours.…”

Section: Discussionmentioning

confidence: 61%

Correlation of Tumour Subtype With Long-term Outcome in Small Breast Carcinomas: A Swedish Population-based Retrospective Cohort Study

Rask

Nazemroaya

Jansson

et al. 2021

Preprint

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Purpose: To investigate if molecular subtype is associated with outcome in stage 1 breast cancer (BC).Method: Tissue samples from 445 women with node-negative BC £15 mm, treated in 1986-2004, were classified into surrogate molecular subtypes (Luminal A-like, Luminal B-like, Her2-positive, and triple negative breast cancer (TNBC)). Information on treatment, recurrences and survival were gathered from medical records. Results: Tumour subtype was not associated with overall survival (OS). Luminal B-like and TNBC were associated with higher incidence of distant metastasis at 20 years. Luminal B-like and TNBC patients also had worse breast cancer specific survival (BCSS), although not statistically significant. Her2-positive BC was not associated with poor outcome despite no patient receiving Her2-targeted therapy.Conclusions: Stage 1 TNBC or Luminal B-like tumours behave more aggressively. Women with Her2+/ER+ tumours do not have an increased risk of distant metastasis or death, absent targeted treatment.

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“…By the original definition, “HER2-enriched” is ER-negative [ 2 ] but many authors define it as HER2 + regardless of hormone receptor status, as was also the case for the present cohort. The rationale behind this is that treatment recommendations generally do not consider ER-status in HER2 + BC [ 21 , 22 ]. In our cohort, most (17/26) HER2 + tumours were ER+, but the BC deaths and the distant recurrences all occurred in the HER2+/ER− subgroup, while locoregional recurrences occurred equally in the HER2+/ER− and HER2+/ER+ groups (data not shown).…”

Section: Discussionmentioning

confidence: 99%

Correlation of tumour subtype with long-term outcome in small breast carcinomas: a Swedish population-based retrospective cohort study

Rask

Nazemroaya

Jansson

et al. 2022

Breast Cancer Res Treat

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Purpose To investigate if molecular subtype is associated with outcome in stage 1 breast cancer (BC). Methods Tissue samples from 445 women with node-negative BC ≤ 15 mm, treated in 1986–2004, were classified into surrogate molecular subtypes [Luminal A-like, Luminal B-like (HER2−), HER2-positive, and triple negative breast cancer (TNBC)]. Information on treatment, recurrences, and survival were gathered from medical records. Results Tumour subtype was not associated with overall survival (OS). Luminal B-like (HER2−) and TNBC were associated with higher incidence of distant metastasis at 20 years (Hazard ratio (HR) 2.26; 95% CI 1.08–4.75 and HR 3.24; 95% CI 1.17–9.00, respectively). Luminal B-like (HER2−) and TNBC patients also had worse breast cancer-specific survival (BCSS), although not statistically significant (HR 1.53; 95% CI 0.70–3.33 and HR 1.89; 95% CI 0.60–5.93, respectively). HER2-positive BC was not associated with poor outcome despite no patient receiving HER2-targeted therapy, with most of these tumours being ER+. Conclusions Stage 1 TNBC or Luminal B-like (HER2−) tumours behave more aggressively. Women with HER2+/ER+ tumours do not have an increased risk of distant metastasis or death, absent targeted treatment.

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Small breast cancers: When and how to treat

Cited by 14 publications

References 70 publications

Outcomes in patients with small node‐negative invasive breast cancer

Outcomes in patients with small node‐negative invasive breast cancer

Correlation of Tumour Subtype With Long-term Outcome in Small Breast Carcinomas: A Swedish Population-based Retrospective Cohort Study

Correlation of tumour subtype with long-term outcome in small breast carcinomas: a Swedish population-based retrospective cohort study

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