Triple negativity and young age as prognostic factors in lymph node-negative invasive ductal carcinoma of 1 cm or less.
BACKGROUND
Whether a systemic adjuvant treatment is needed is an area of controversy in patients with node-negative early breast cancer with tumor size of ≤1 cm, including T1mic.


METHODS
We performed a retrospective analysis of clinical and pathology data of all consecutive patients with node-negative T1mic, T1a, and T1b invasive ductal carcinoma who received surgery between Jan 2000 and Dec 2006. The recurrence free survival (RFS) and risk factors for recurrence were identified.


RESULTS
Out of 3889 patients diagnosed with breast cancer, 375 patients were enrolled (T1mic:120, T1a:93, T1b:162). Median age at diagnosis was 49. After a median follow up of 60.8 months, 12 patients developed recurrences (T1mic:4 (3.3%), T1a:2 (2.2%), T1b:6 (3.7%)), with a five-year cumulative RFS rate of 97.2%. Distant recurrence was identified in three patients. Age younger than 35 years (HR 4.91; 95% CI 1.014-23.763, p = 0.048) and triple negative disease (HR 4.93; 95% CI 1.312-18.519, p = 0.018) were significantly associated with a higher rate of recurrence. HER2 overexpression, Ki-67, and p53 status did not affect RFS.


CONCLUSIONS
Prognosis of node-negative breast cancer with T1mic, T1a and T1b is excellent, but patients under 35 years of age or with triple negative disease have a relatively high risk of recurrence.
Kwon
Ji Hyun
JH
Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Kim
Yu Jung
YJ
Lee
Keun-Wook
KW
Oh
Do-Youn
DY
Park
So Yeon
SY
Kim
Jee Hyun
JH
Chie
Eui Kyu
EK
Kim
Sung-Won
SW
Im
Seock-Ah
SA
Kim
In-Ah
IA
Kim
Tae-You
TY
Park
In Ae
IA
Noh
Dong-Young
DY
Bang
Yung-Jue
YJ
Ha
Sung Whan
SW
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000378:metabolism*; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism*; D018572:Disease-Free Survival; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D019394:Ki-67 Antigen / Q000096:biosynthesis; D008207:Lymphatic Metastasis; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen