title: Influence of uncommon histology on breast conservation therapy for breast cancer-biology dictates technique?
abstract: BACKGROUND
  Although trends and variations in the use of breast conservation therapy (BCT) for ductal carcinoma have been studied, little is known about uncommon breast cancer histologies.
  
  
  METHODS
  The Surveillance, Epidemiology and End Results (SEER) database was used to identify 338,682 patients with T1 or T2 (≤5 cm) ductal, lobular, tubular, mucinous, medullary, or papillary carcinoma of the breast from 1998 to 2008. Multivariate logistic regression analysis was used to identify predictors of BCT.
  
  
  RESULTS
  The majority of patients underwent BCT (60%). The rate of BCT remained relatively constant from 1998 to 2008 overall but varied from 50% for lobular to 79% for tubular. The highest rate of mastectomy was seen in lobular (49%). Nodal positivity following surgical staging was lowest for tubular (6%) and mucinous (8%). Adjuvant radiation was given to 72% overall and was lowest for papillary (58%). Predictors of BCT included tubular (OR 1.8, 95% CI 1.7-1.9) and medullary (OR 2.0, 95% CI 1.8-2.2) subtypes (vs. ductal).
  
  
  CONCLUSIONS
  Patients with uncommon breast cancer histologies show wide variation in the application of BCT depending on the primary tumor. This suggests that an individualized approach in the use of BCT depending on histology should be used.
authors: Department of Surgery, Mayo Clinic Arizona, Phoenix, AZ 85054, USA. wasif.nabil@mayo.edu
authors: Nabil
authors: N
authors: Wasif
authors: Ann E
authors: AE
authors: McCullough
authors: Richard J
authors: RJ
authors: Gray
authors: Barbara A
authors: BA
authors: Pockaj
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy*; D002277:Carcinoma / Q000378:metabolism / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008408:Mastectomy / Q000706:statistics & numerical data; D015412:Mastectomy, Segmental; D008875:Middle Aged; D015999:Multivariate Analysis; D044469:Racial Groups / Q000706:statistics & numerical data; D018714:Radiotherapy, Adjuvant; D011960:Receptors, Estrogen / Q000378:metabolism; D018426:SEER Program; D014481:United States
chemical_list: D011960:Receptors, Estrogen