Abstract 2221
Background
The universalisation of mammographic screening has caused an increase in ultralow risk breast cancer diagnosis. Identifying subgroups with no events related to mortality due to breast cancer in the long term (overdiagnosis) may be useful so as not to subject them to unnecessary treatment (overtreatment).
Methods
New ultralow risk criteria are described by means of mammographic screening diagnosis, tumour palpability, tumour phenotype, and absence of axillary node involvement. We identified patients with no events related to breast cancer mortality through a descriptive, observational, and retrospective study.
Results
Among the 746 patients with stage I and IIA breast cancer attended between 1/1/2001 and 31/12/2014, 110 (14.75%) came from mammographic screening with non-palpable tumours. The median age was 58 years old (38-71). 88 (80%) were hormone receptor positive (HR+), 10 (9.10%) were triple negatives, and 11 (10%) were HER-2. The median follow-up was 10 years (3.5-17). Only 3 patients developed metastasis, there were no loco-regional recurrence, 7 showed second primary tumours, and there were 4 deaths, 2 due to breast cancer and 2 due to other reasons. Overall survival (OS) was 92.80%, disease-free survival (DFS) was 85.20%, and the distant metastasis-free interval (DMFI) was 95.60%. In 88 patients with HR+ tumours, OS was 95.7%, DFS was 86.50%, and DMFI was 96.30%. In 34 (38.60%) histological grade 1 HR+ tumours (probably Luminal A), and in 54 (61.40%) histological grade 2-3 HR+ tumours (probably Luminal B), OS was 93.80% and 96.90% (p = 0.669), DFS was 81.90% and 89.30% (p = 0.400), and DMFI was 100% and 94.40% (p = 0.307). In triple negatives, OS was 85.70%, DFS 77.10%, and DMFI was 100%. In subgroup HER-2, there were no events. In tumours smaller and larger than 1 cm, OS was 100% and 90.20% (p = 0.168), DFS was 93.20% and 84.10% (p = 0.742), and DMFI was 100% and 95.50% (p = 0.296).
Conclusions
Patients with non-palpable tumours detected in mammographic screening have an ultralow risk. The absence of events related to breast cancer mortality makes them candidates for overdiagnosis. De-escalation of treatment should be considered. The authors will incorporate genomic risk to optimise the identification of overdiagnosis.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3902 - The efficacy of preoperative breast cancer chemotherapy without anti-HER2-targeted treatment – single center experience in setting of no reimbursement in Poland (2011-2015)
Presenter: Agnieszka Badora-Rybicka
Session: Poster Display session 2
Resources:
Abstract
4733 - A Multicentre, International Neoadjuvant (NA), Randomized, Double-blind Phase III Trial comparing FULVESTRANT to a combination of FULVESTRANT and PALBOCICLIB in patients with operable Luminal Breast Cancer (SAFIA Trial)
Presenter: Jean-Marc Nabholtz
Session: Poster Display session 2
Resources:
Abstract
5227 - Outcome of Non-metastatic Male Breast Cancer: 222 patients
Presenter: Ulku Yalcintas Arslan
Session: Poster Display session 2
Resources:
Abstract
5943 - Effects of delayed initiation of adjuvant trastuzumab for non-metastatic, Her2 positive breast cancer in a limited resources setting: ML25232 study final results
Presenter: Samir Beslija
Session: Poster Display session 2
Resources:
Abstract
1725 - Final results of scalp cooling for hair preservation: A single- institution prospective study.
Presenter: Dario Loparco
Session: Poster Display session 2
Resources:
Abstract
3713 - Adjuvant Systemic Therapy in Women with Early Breast Cancer and Intermediate Prosigna ROR Scores: Is Chemotherapy Use Declining? Evidence From a Large Practice
Presenter: Lowell Hart
Session: Poster Display session 2
Resources:
Abstract
818 - Management of early breast cancer in women over 90: A 10 year experience
Presenter: Emily Coffey
Session: Poster Display session 2
Resources:
Abstract
1141 - Evolution in the risk of adverse events of adjuvant endocrine therapy in postmenopausal women with early- stage breast cancer.
Presenter: Daniel Reinhorn
Session: Poster Display session 2
Resources:
Abstract
2277 - Hepatitis B screening and incidence of flare among non-metastatic breast cancer patients treated with anthracyclines
Presenter: Zewen Zhang
Session: Poster Display session 2
Resources:
Abstract
2781 - Effect of denosumab on low bone mineral density in postmenopausal Japanese early breast cancer patients receiving aromatase nhibitors : 36-month results
Presenter: Koichi Sakaguchi
Session: Poster Display session 2
Resources:
Abstract