title: Palpable breast cancers are inherently different from nonpalpable breast cancers.
abstract: BACKGROUND
  We examined the clinicopathologic profile of T1 cancers to determine whether palpable cancers are different from nonpalpable cancers.
  
  
  METHODS
  A prospective database was reviewed. Palpable T1 cancers were compared with nonpalpable T1 cancers. Initial significance was determined by chi2 analysis. Factors found to be significant were then reanalyzed. controlling for tumor size by logistic or linear regression, as appropriate.
  
  
  RESULTS
  Of 1263 T1 cancers treated between 1981 and 2000, 857 (68%) were palpable and 401 (32%) were nonpalpable. Palpability correlated with pathologic tumor size, mitotic grade, nuclear grade, high S-phase, lymphovascular invasion, nodal positivity, and lack of extensive intraductal component, multifocality, and multicentricity. There was no significant difference in estrogen receptor, progesterone receptor or Her-2/neu status, ploidy, or DNA index. Breast cancer-specific survival was worse for patients with palpable cancers.
  
  
  CONCLUSIONS
  Palpable cancers are inherently different from nonpalpable cancers, with a less diffuse growth pattern, higher metastatic potential, higher proliferative activity, more nuclear abnormalities, and a worse prognosis.
authors.affiliation: Department of Surgery, Norris Comprehensive Cancer Center, Keck School of Medicine, The University of Southern California, Los Angeles 90033, USA. kskinner@hsc.usc.edu
authors.forename: K A
authors.initials: KA
authors.lastname: Skinner
authors.forename: H
authors.initials: H
authors.lastname: Silberman
authors.forename: R
authors.initials: R
authors.lastname: Sposto
authors.forename: M J
authors.initials: MJ
authors.lastname: Silverstein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010173:Palpation; D011379:Prognosis; D011446:Prospective Studies