title: Prognostic significance of triple negative breast cancer at tumor size 1 cm and smaller.
abstract: OBJECTIVE
  The purpose of this study was to clarify the prognostic significance of triple-negative breast cancer (TNBC) with a tumor size ≤ 1 cm.
  
  
  METHODS
  Patients with primary operable breast cancer with a tumor size ≤ 1 cm were enrolled at Changhua Christian Hospital and National Cheng-Kung University Hospital. Tumors negative for ER, PR, and HER-2 were classified as TNBCs and compared with tumors with any receptor positivity (non-TNBC) for disease-free survival (DFS) and cancer-specific survival (CSS).
  
  
  RESULTS
  From 1995 to 2006, a total of 377 patients with tumor size ≤ 1 cm were enrolled. Compared with non-TNBC patients, TNBC patients with a tumor size ≤ 1 cm as a whole or in a lymph node-positive subgroup were not associated with a poorer 5-year DFS and CSS. In lymph node-negative patients (pT1a-bN0M0), TNBC was associated with a poorer 5-year CSS but not DFS. Compared with the hormone receptor-positive, HER-2-negative subgroup, TNBC was associated with poorer DFS and CSS. In the multivariate Cox regression hazard analysis, lymph node invasion was the most important cause of disease recurrence and cancer-specific death.
  
  
  CONCLUSIONS
  TNBC is very likely an independent risk factor in small (≤1 cm) node-negative invasive breast cancer. With tumors 1 cm and smaller, lymph node invasion was the single most important prognostic factor.
authors.affiliation: Department of Surgery, Changhua Christian Hospital, 135 Nanhsiao Street, Changhua, Taiwan.
authors.forename: H W
authors.initials: HW
authors.lastname: Lai
authors.forename: S J
authors.initials: SJ
authors.lastname: Kuo
authors.forename: L S
authors.initials: LS
authors.lastname: Chen
authors.forename: C W
authors.initials: CW
authors.lastname: Chi
authors.forename: S T
authors.initials: ST
authors.lastname: Chen
authors.forename: T W
authors.initials: TW
authors.lastname: Chang
authors.forename: D R
authors.initials: DR
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D012307:Risk Factors; D055815:Young Adult
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone