Small Invasive Carcinomas of the Breast (T1a, T1b): The Importance of an Extended Follow Up
Joana Loureiro, Paula Monteiro, Clara Castro, Maria Jose Bento, Conceicao Leal. Portuguese Oncology Institute, Porto, Portugal
Background: Over the past years diagnosis of invasive breast carcinomas measuring ≤1cm has increased. These women generally have good long-term outcomes, but not all. The aim of this study was to investigate whether women at high risk of breast-cancer death could be identified based on clinical and pathological features.
Design: The cohort included 49 invasive breast carcinomas with ≤1cm, consecutively diagnosed in 1995 and 1996. Clinical and morphological features were reviewed and immunohistochemical studies were performed. Association of these variables with axillary lymph node metastases (LNm), recurrences, distant metastases (Dm) and survival was analyzed.
Results: Patients had between 26 and 83 year-old (mean 57.7 year-old), 39 (79.6%) had stage I, 6 (12.2%) stage IIA, 1 (2.1%) stage IIIA and in 3 (6.1%) LN dissection was not performed. Morphologically, most tumors (n=39, 79,6%) were ductal and grade 1 or 2, and 28 (57.1%) had an extensive “in situ” component. All except one were hormone receptors positive, HER2 was positive in 8 (16.3%) tumors and 19 (38.8%) tumors had Ki-67>14%. In 4 cases material for immunohistochemical studies were not available. Using molecular classification, 22 (49.9%) tumors were Luminal A, 15 (30.6%) Luminal B (HER-), 7 (14.3%) Luminal B (HER+) and 1 (2.0%) Her+. Average time of follow-up was 171 months (50 up to 210): 36 (75.5%) patients are alive without evidence of disease, 9 (18.4%) died of other causes and 3 (6.1%) died of disease. Recurrences and Dm occurred from 73 months up to 152 months after diagnosis (mean 119 months). Only stage I patients had recurrences (n=7, two of whom died) or Dm (n=1, dead). None of the clinical or pathological parameters evaluated were statistically significant for these events. Only T1b tumors (≥0.7cm) had LNm. Patients with LNm (n=7, 14.3%) had no recurrences or Dm and are alive without evidence of disease.
Conclusions: In this series, overall prognosis is good even for patients with LNm. Larger series and more molecular studies are needed to find out predictive factors for these carcinomas. Our work highlights the need for an extended follow up as recurrences occured as late as 152 months after diagnosis.
Wednesday, March 6, 2013 9:30 AM
Poster Session V # 44, Wednesday Morning