Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1981 Jan;193(1):15–25. doi: 10.1097/00000658-198101000-00003

Predictors of recurrence in stage I (T1N0M0) breast carcinoma.

P P Rosen, P E Saigo, D W Braun Jr, E Weathers, A DePalo
PMCID: PMC1344996  PMID: 7458446

Abstract

A ten-year follow-up study of 382 women with Stage I (T1N0M0) breast carcinoma revealed recurrence and/or death due to cancer in 16% of the patients. Among 134 patients (35%) with a primary tumor 1.0 cm or less in diameter (Group A), 7% had recurrences and 5% died of breast carcinoma. Recurrences were observed in 21% of the 248 women with a tumor 1.1-2.0 cm in diameter (Group B), and 15% died of disease. These differences in recurrence and mortality rates were statistically significant. All recurrences were due to infiltrating duct or lobular carcinoma which accounted for 91% of the 382 carcinomas. Most strongly linked to recurrence was the finding of tumor emboli in lymphatics of the breast. This was found in 23 Group B patients and ten of them (43%) died of disease. No recurrences were observed among the seven Group A patients with lymphatic emboli. Other features associated with a significantly increased risk of recurrence were poorly differentiated carcinoma, marked lymphoid reaction to tumor, and menarche before age 12 years or after age 14 years. No combination of variables proved to identify a subset of patients with an especially increased or low risk of recurrence. Stage I patients with lymphatic tumor emboli in the breast surrounding a carcinoma 1.1-2.0 cm in diameter have a sufficient risk for recurrence to warrant consideration of adjuvant systemic therapy. A very low risk of recurrence was observed for the following: any tumor 1.0 cm or smaller; and tubular, medullary or colloid carcinoma up to 2.0 cm.

Full text

PDF
15

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adair F., Berg J., Joubert L., Robbins G. F. Long-term followup of breast cancer patients: the 30-year report. Cancer. 1974 Apr;33(4):1145–1150. doi: 10.1002/1097-0142(197404)33:4<1145::aid-cncr2820330438>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
  2. BLACK M. M., SPEER F. D. Nuclear structure in cancer tissues. Surg Gynecol Obstet. 1957 Jul;105(1):97–102. [PubMed] [Google Scholar]
  3. BLOOM H. J. G. Prognosis in carcinoma of the breast. Br J Cancer. 1950 Sep;4(3):259–288. doi: 10.1038/bjc.1950.26. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bell J. R., Friedell G. H., Goldenberg I. S. Prognostic significance of pathologic findings in human breast carcinoma. Surg Gynecol Obstet. 1969 Aug;129(2):258–262. [PubMed] [Google Scholar]
  5. Berg J. W., Robbins G. F. Factors influencing short and long term survival of breast cancer patients. Surg Gynecol Obstet. 1966 Jun;122(6):1311–1316. [PubMed] [Google Scholar]
  6. Brinkley D., Haybittle J. L. The curability of breast cancer. World J Surg. 1977 May;1(3):287–289. doi: 10.1007/BF01556839. [DOI] [PubMed] [Google Scholar]
  7. Champion H. R., Wallace I. W., Prescott R. J. Histology in breast cancer prognosis. Br J Cancer. 1972 Apr;26(2):129–138. doi: 10.1038/bjc.1972.19. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Contesso G., Rouëssé J., Caen J. L. Facteurs anatomo-pathologiques du pronostic des cancers du sein. Ann Anat Pathol (Paris) 1973 Oct-Dec;18(4):374–388. [PubMed] [Google Scholar]
  9. FRIEDELL G. H., BETTS A., SOMMERS S. C. THE PROGNOSTIC VALUE OF BLOOD VESSEL INVASION AND LYMPHOCYTIC INFILTRATES IN BREAST CARCINOMA. Cancer. 1965 Feb;18:164–166. doi: 10.1002/1097-0142(196502)18:2<164::aid-cncr2820180207>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
  10. Feig S. A., Shaber G. S., Patchefsky A., Schwartz G. F., Edeiken J., Libshitz H. I., Nerlinger R., Curley R. F., Wallace J. D. Analysis of clinically occult and mammographically occult breast tumors. AJR Am J Roentgenol. 1977 Mar;128(3):403–408. doi: 10.2214/ajr.128.3.403. [DOI] [PubMed] [Google Scholar]
  11. Fracchia A. A., Rosen P. P., Ashikari R. Primary carcinoma of the breast without axillary lymph node metastases. Surg Gynecol Obstet. 1980 Sep;151(3):375–378. [PubMed] [Google Scholar]
  12. Juret P., Couette J. E., Mandard A. M., Carré A., Delozier T., Brune D., Vernhes J. C. Age at menarche as a prognostic factor in human breast cancer. Eur J Cancer. 1976 Sep;12(9):701–704. doi: 10.1016/0014-2964(76)90019-0. [DOI] [PubMed] [Google Scholar]
  13. Kister S. J., Sommers S. C., Haagensen C. D., Cooley E. Re-evaluation of blood-vessel invasion as a prognostic factor in carcinoma of the breast. Cancer. 1966 Sep;19(9):1213–1216. doi: 10.1002/1097-0142(196609)19:9<1213::aid-cncr2820190906>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]
  14. LANE N., GOKSEL H., SALERNO R. A., HAAGENSEN C. D. Clinico-pathologic analysis of the surgical curability of breast cancers: a minimum ten-year study of a personal series. Ann Surg. 1961 Apr;153:483–498. doi: 10.1097/00000658-196104000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Meyer J. S., Hixon B. Advanced stage and early relapse of breast carcinomas associated with high thymidine labeling indices. Cancer Res. 1979 Oct;39(10):4042–4047. [PubMed] [Google Scholar]
  16. Nealon T. F., Jr, Nkongho A., Grossi C., Gillooley J. Pathologic identification of poor prognosis stage I (T1N0M0) cancer of the breast. Ann Surg. 1979 Aug;190(2):129–132. doi: 10.1097/00000658-197908000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Nime F. A., Rosen P. P., Thaler H. T., Ashikari R., Urban J. A. Prognostic significance of tumor emboli in intramammary lymphatics in patients with mammary carcinoma. Am J Surg Pathol. 1977 Mar;1(1):25–30. doi: 10.1097/00000478-197701010-00003. [DOI] [PubMed] [Google Scholar]
  18. Peto R., Pike M. C. Conservatism of the approximation sigma (O-E)2-E in the logrank test for survival data or tumor incidence data. Biometrics. 1973 Sep;29(3):579–584. [PubMed] [Google Scholar]
  19. Ridolfi R. L., Rosen P. P., Port A., Kinne D., Miké V. Medullary carcinoma of the breast: a clinicopathologic study with 10 year follow-up. Cancer. 1977 Oct;40(4):1365–1385. doi: 10.1002/1097-0142(197710)40:4<1365::aid-cncr2820400402>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  20. Rosen P. P., Menendez-Botet C. J., Nisselbaum J. S., Urban J. A., Miké V., Fracchia A., Schwartz M. K. Pathological review of breast lesions analyzed for estrogen receptor protein. Cancer Res. 1975 Nov;35(11 Pt 1):3187–3194. [PubMed] [Google Scholar]
  21. Rosen P. P. The pathological classification of human mammary carcinoma: past, present and future. Ann Clin Lab Sci. 1979 Mar-Apr;9(2):144–156. [PubMed] [Google Scholar]
  22. Sampat M. B., Sirsat M. V., Gangadharan P. Prognostic significance of blood vessel invasion in carcinoma of the breast in women. J Surg Oncol. 1977;9(6):623–632. doi: 10.1002/jso.2930090613. [DOI] [PubMed] [Google Scholar]
  23. Silverberg S. G., Chitale A. R., Levitt S. H. Prognostic significance of tumor margins in mammary carcinoma. Arch Surg. 1971 May;102(5):450–454. doi: 10.1001/archsurg.1971.01350050016005. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES