271P - Favorable results of patients with pT1a,b,c, lymph node-negative early breast cancer in long-interval

Date 29 September 2014
Event ESMO 2014
Session Poster Display session
Topics Breast Cancer
Presenter Nilufer Bulut
Citation Annals of Oncology (2014) 25 (suppl_4): iv85-iv109. 10.1093/annonc/mdu327
Authors N. Bulut1, M.K. Altundag2
  • 1Medical Oncology, ali osman sönmez, 16660 - bursa/TR
  • 2Medical Oncology, Hacettepe University Oncology Institutte, 06 - ankara/TR

Abstract

Aim

We aimed to investigate retrospectively the overall prognosis of lymph node-negative invasive ductal carcinoma of the breast of ≤ 2 cm in size. We evaluated prognostic and predictive factors in subgroups of patients, and also we determined some of the patients who would be candidates for systemic adjuvant and hormonal therapies.

Methods

This analysis included women with breast cancer diagnosed from 1981 to 2013 in our clinic. Tumors were graded according to theTNM. T1a,b,c N0M0 is a stage I breast cancers that were classified, where T1a is no more than 0.5 cm, T1b is 0.6 to 1.0 cm and T1c is more than 1 cm but more than 2 cm.

Results

A total of 579 patients were included in the study. Median age was 54 (range, 27 to 86 years) and similar among patients with T1a, T1b, T1c tumors. 280 patients (48.8%) received a mastectomy, and breast-conserving surgery (BCS) was performed in 297 women (51.9%). Among patients who received BCS, 297 patients (51.9%) were treated with adjuvant radiotherapy after surgical resection. 171 patients (29.6%) received systemic adjuvant therapy. Median follow-up was 4.2 years. In patients with T1a,b,c, the disease-free survival (DFS) rate was 98.4%, 100%, and 100 % in the second years, respectively (p = 0.000). At 10 years DFS rates of T1a, T1b, and T1c patients were 95.7%, 100%, and 100%, respectively (p = 0.000). There was a difference in twenty -year DFS between T1b and T1c patients ( 100% for T1b, 80% for T1c, p = 0.000). In subgroup analysis of T1; 2 and 10 years DFS rates were 99.7%, 93.4% in HR + /HER2-, 100 %, 100 % in HR-/HER2-, 100%, 100% in HR-/HER2+ patients, respectively. There was no significant difference between HR + /HER2-, HR-/HER2- and HR-/HER2+ subgroups (p = 0.917).

Conclusions

In conclusion, all T1 breast cancers showed to have excellent long-term outcome regardless of initial treatment. Recurrences and deaths are known to occur, even if less frequently, in patients with small, node-negative breast cancers, and the decision on adjuvant treatments remains controversial. The introduction of molecular subtypes and gene signatures improve the complexity of early breast cancer treatment, and individual institutes have to establish their policy based on their histopathological information and the availability of gene signatures.

Disclosure

All authors have declared no conflicts of interest.