Differences between palpable and nonpalpable tumors in early-stage, hormone receptor-positive breast cancer

Stephanie L. Warren, Neal Bhutiani, Steven Agle, Robert C.G. Martin, Kelly M. McMasters, Nicolas Ajkay

Research output: Contribution to journalArticle

Abstract

Background: We compared characteristics and outcomes of palpable versus nonpalpable, hormone-sensitive, early-stage breast cancers. Methods: Patients from the North American Fareston vs. Tamoxifen Adjuvant (NAFTA) trial were divided into palpable (n = 513) and nonpalpable (n = 1063) tumor groups. Differences in pathological features, loco-regional therapy, disease-free survival (DFS) and overall survival (OS) were analyzed. Results: Patients with palpable tumors were older, had larger tumors, and higher rates of lymph-node involvement. The tumors were more likely to be poorly differentiated, of high nuclear grade, and display lymphovascular invasion. After mean followup of 59 months, DFS and OS were significantly lower for palpable than nonpalpable tumors (DFS 93.5% vs. 98.4%, p < 0.001, OS 88.5% vs. 95.6%, p < 0.001). Controlling for age, size and nodal status, palpability was an independent factor for DFS (OR = 2.56; 95%CI, 1.37–4.79, p = 0.003) and OS (OR = 2.12; 95%CI, 1.38–3.28, p < 0.001). Conclusions: In a group of hormone-sensitive, mostly postmenopausal early-stage breast cancer patients, palpable tumors were more likely to have more aggressive features and metastatic potential, which translated in to a higher incidence of breast cancer-related events and worse overall survival.

Original languageEnglish (US)
JournalAmerican Journal of Surgery
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Hormones
Breast Neoplasms
Disease-Free Survival
Survival
Neoplasms
Toremifene
Tamoxifen
Lymph Nodes
Incidence
Therapeutics

ASJC Scopus subject areas

  • Surgery

Cite this

Differences between palpable and nonpalpable tumors in early-stage, hormone receptor-positive breast cancer. / Warren, Stephanie L.; Bhutiani, Neal; Agle, Steven; Martin, Robert C.G.; McMasters, Kelly M.; Ajkay, Nicolas.

In: American Journal of Surgery, 01.01.2018.

Research output: Contribution to journalArticle

Warren, Stephanie L. ; Bhutiani, Neal ; Agle, Steven ; Martin, Robert C.G. ; McMasters, Kelly M. ; Ajkay, Nicolas. / Differences between palpable and nonpalpable tumors in early-stage, hormone receptor-positive breast cancer. In: American Journal of Surgery. 2018.
@article{7a05b3a89a8e4e058087f97692d6943a,
title = "Differences between palpable and nonpalpable tumors in early-stage, hormone receptor-positive breast cancer",
abstract = "Background: We compared characteristics and outcomes of palpable versus nonpalpable, hormone-sensitive, early-stage breast cancers. Methods: Patients from the North American Fareston vs. Tamoxifen Adjuvant (NAFTA) trial were divided into palpable (n = 513) and nonpalpable (n = 1063) tumor groups. Differences in pathological features, loco-regional therapy, disease-free survival (DFS) and overall survival (OS) were analyzed. Results: Patients with palpable tumors were older, had larger tumors, and higher rates of lymph-node involvement. The tumors were more likely to be poorly differentiated, of high nuclear grade, and display lymphovascular invasion. After mean followup of 59 months, DFS and OS were significantly lower for palpable than nonpalpable tumors (DFS 93.5{\%} vs. 98.4{\%}, p < 0.001, OS 88.5{\%} vs. 95.6{\%}, p < 0.001). Controlling for age, size and nodal status, palpability was an independent factor for DFS (OR = 2.56; 95{\%}CI, 1.37–4.79, p = 0.003) and OS (OR = 2.12; 95{\%}CI, 1.38–3.28, p < 0.001). Conclusions: In a group of hormone-sensitive, mostly postmenopausal early-stage breast cancer patients, palpable tumors were more likely to have more aggressive features and metastatic potential, which translated in to a higher incidence of breast cancer-related events and worse overall survival.",
author = "Warren, {Stephanie L.} and Neal Bhutiani and Steven Agle and Martin, {Robert C.G.} and McMasters, {Kelly M.} and Nicolas Ajkay",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.amjsurg.2018.02.020",
language = "English (US)",
journal = "American Journal of Surgery",
issn = "0002-9610",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Differences between palpable and nonpalpable tumors in early-stage, hormone receptor-positive breast cancer

AU - Warren, Stephanie L.

AU - Bhutiani, Neal

AU - Agle, Steven

AU - Martin, Robert C.G.

AU - McMasters, Kelly M.

AU - Ajkay, Nicolas

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: We compared characteristics and outcomes of palpable versus nonpalpable, hormone-sensitive, early-stage breast cancers. Methods: Patients from the North American Fareston vs. Tamoxifen Adjuvant (NAFTA) trial were divided into palpable (n = 513) and nonpalpable (n = 1063) tumor groups. Differences in pathological features, loco-regional therapy, disease-free survival (DFS) and overall survival (OS) were analyzed. Results: Patients with palpable tumors were older, had larger tumors, and higher rates of lymph-node involvement. The tumors were more likely to be poorly differentiated, of high nuclear grade, and display lymphovascular invasion. After mean followup of 59 months, DFS and OS were significantly lower for palpable than nonpalpable tumors (DFS 93.5% vs. 98.4%, p < 0.001, OS 88.5% vs. 95.6%, p < 0.001). Controlling for age, size and nodal status, palpability was an independent factor for DFS (OR = 2.56; 95%CI, 1.37–4.79, p = 0.003) and OS (OR = 2.12; 95%CI, 1.38–3.28, p < 0.001). Conclusions: In a group of hormone-sensitive, mostly postmenopausal early-stage breast cancer patients, palpable tumors were more likely to have more aggressive features and metastatic potential, which translated in to a higher incidence of breast cancer-related events and worse overall survival.

AB - Background: We compared characteristics and outcomes of palpable versus nonpalpable, hormone-sensitive, early-stage breast cancers. Methods: Patients from the North American Fareston vs. Tamoxifen Adjuvant (NAFTA) trial were divided into palpable (n = 513) and nonpalpable (n = 1063) tumor groups. Differences in pathological features, loco-regional therapy, disease-free survival (DFS) and overall survival (OS) were analyzed. Results: Patients with palpable tumors were older, had larger tumors, and higher rates of lymph-node involvement. The tumors were more likely to be poorly differentiated, of high nuclear grade, and display lymphovascular invasion. After mean followup of 59 months, DFS and OS were significantly lower for palpable than nonpalpable tumors (DFS 93.5% vs. 98.4%, p < 0.001, OS 88.5% vs. 95.6%, p < 0.001). Controlling for age, size and nodal status, palpability was an independent factor for DFS (OR = 2.56; 95%CI, 1.37–4.79, p = 0.003) and OS (OR = 2.12; 95%CI, 1.38–3.28, p < 0.001). Conclusions: In a group of hormone-sensitive, mostly postmenopausal early-stage breast cancer patients, palpable tumors were more likely to have more aggressive features and metastatic potential, which translated in to a higher incidence of breast cancer-related events and worse overall survival.

UR - http://www.scopus.com/inward/record.url?scp=85042670558&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85042670558&partnerID=8YFLogxK

U2 - 10.1016/j.amjsurg.2018.02.020

DO - 10.1016/j.amjsurg.2018.02.020

M3 - Article

AN - SCOPUS:85042670558

JO - American Journal of Surgery

JF - American Journal of Surgery

SN - 0002-9610

ER -