title: Outcome and Medial Presentation of Breast Cancer: European Institute of Oncology Experience.
abstract: BACKGROUND
  No analyses have investigated the prognostic role of medial presentation in breast cancer patients on disease-free survival (DFS) and overall survival according to immunohistochemically-defined subtypes.
  
  
  METHODS
  We collected information from the institutional clinical database on consecutive breast cancer patients who underwent conservative surgery at the European Institute of Oncology, Milan, Italy, between 1994 and 2008. We compared the outcomes of patients with medial breast cancer with those of patients with nonmedial tumors observed at the institution during the same period.
  
  
  RESULTS
  Among 7369 evaluable patients, 2254 (24%) had their primary tumors in medial quadrants and 7015 (76%) in other areas. Five-year DFS was 84.7% and 86.6% (P = .008) in patients with medial and nonmedial disease, respectively. In multivariate analysis, medial location was correlated with greater risk of recurrence (hazard ratio [HR], 1.23; 95% confidence interval [CI], 1.11-1.35; P < .0001) and death (HR, 1.27; 95% CI, 1.09-1.49; P = .0028).
  
  
  CONCLUSIONS
  Medial presentation is an adverse prognostic factor for breast cancer patients.
authors.affiliation: Division of Medical Senology, European Institute of Oncology, Milan, Italy. Electronic address: emilia.montagna@ieo.it.
authors.forename: Emilia
authors.initials: E
authors.lastname: Montagna
authors.affiliation: Department of Quantitative Methods and Statistics, University of Milan-Bicocca, Milan, Italy; Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bagnardi
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Nicole
authors.initials: N
authors.lastname: Rotmensz
authors.affiliation: Department of Pathology, European Institute of Oncology, Milan, Italy; School of Medicine, University of Milan, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Viale
authors.affiliation: Division of Medical Senology, European Institute of Oncology, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Cancello
authors.affiliation: Division of Medical Senology, European Institute of Oncology, Milan, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Palazzo
authors.affiliation: Division of Senology, European Institute of Oncology, Milan, Italy.
authors.forename: Viviana
authors.initials: V
authors.lastname: Galimberti
authors.affiliation: Division of Senology, European Institute of Oncology, Milan, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Veronesi
authors.affiliation: Division of Senology, European Institute of Oncology, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Luini
authors.affiliation: Department of Pathology, European Institute of Oncology, Milan, Italy.
authors.forename: Mauro G
authors.initials: MG
authors.lastname: Mastropasqua
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Santillo
authors.affiliation: Program of Senology (Breast Health), European Institute of Oncology, Milan, Italy.
authors.forename: Aron
authors.initials: A
authors.lastname: Goldhirsch
authors.affiliation: Division of Medical Senology, European Institute of Oncology, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Colleoni
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007558:Italy; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models
keywords: Luminal; Position; Subtypes; Triple negative; Tumor