Metastatic Potential of Small and Minimally Invasive Breast Carcinomas

Overview

Journal Virchows Arch

Specialties Cell Biology
Molecular Biology
Pathology

Date 1994 Jan 1

PMID 7812508

Citations 1

Authors

H P Sinn

A Oelmann

H W Anton

I J Diel

Affiliations

Soon will be listed here.

Abstract

Invasive ductal mammary carcinomas (IDC) of 1 cm in tumour size or less account for less than 20% of all IDC. We have observed 167 such cases at our Institution between 1985 and 1989. These were divided into carcinomas with an extensive or predominant intraductal component (EIC or PIC, being least 2x or 4x larger than the invasive component; 90) and compared statistically with the control group (no EIC or PIC; 77) for known prognostic factors and for their metastatic behaviour. Lymph nodes were step sectioned in order to detect occult micrometastases. The median follow up time was 62.6 months. Lymph node metastases were seen in 10% of pT1a and 19% of pT1b cases. Significant differences were found when comparing the EIC/PIC group with the control group (pT1a: 11% vs. 0%, pT1b: 37% vs. 11% lymph node metastases). Also, axillary and infraclavicular recurrence rates were higher for EIC/PIC carcinomas compared with other IDC of < or = 1 cm (9.3% vs. 4.2%). This significantly adverse metastatic behaviour of the EIC/PIC tumours may be in part due to the more frequent occurrence of multifocal tumours in this group (in 43% vs. 6%), resulting in a greater tumour burden. We conclude that the overall risk of lymph node metastasis is not negligible in carcinomas of 1 cm or less in diameter with the risk being more than doubled for carcinomas with an intraductal component exceeding the invasive tumour by a factor of two. These differences were relevant only to regional metastases; the risk for distant metastasis and survival was identical after 5 years.

Citing Articles

Minimal breast cancer: evaluation of histology and biological marker expression.

Dublin E, Millis R, Smith P, Bobrow L Br J Cancer. 1999; 80(10):1608-16.

PMID: 10408407 PMC: 2363109. DOI: 10.1038/sj.bjc.6690570.

References

BASSLER R, Bocker W, Hermanek P, Pickartz H, Prechtel K, Schauer A . [Current status of grading in breast cancer]. Pathologe. 1992; 13(3):130-4. View

Leopold K, Recht A, Schnitt S, Connolly J, Rose M, Silver B . Results of conservative surgery and radiation therapy for multiple synchronous cancers of one breast. Int J Radiat Oncol Biol Phys. 1989; 16(1):11-6. DOI: 10.1016/0360-3016(89)90004-7. View

Kinne D . Surgical management of stage I and stage II breast cancer. Cancer. 1990; 66(6 Suppl):1373-7. DOI: 10.1002/1097-0142(19900915)66:14+<1373::aid-cncr2820661412>3.0.co;2-0. View

Veronesi U . Clinical management of minimal breast cancer. Semin Surg Oncol. 1989; 5(2):145-50. DOI: 10.1002/ssu.2980050211. View

Solin L, Fowble B, Schultz D, Goodman R . Age as a prognostic factor for patients treated with definitive irradiation for early stage breast cancer. Int J Radiat Oncol Biol Phys. 1989; 16(2):373-81. DOI: 10.1016/0360-3016(89)90333-7. View

Schnitt S, Connolly J, Khettry U, Mazoujian G, Brenner M, Silver B . Pathologic findings on re-excision of the primary site in breast cancer patients considered for treatment by primary radiation therapy. Cancer. 1987; 59(4):675-81. DOI: 10.1002/1097-0142(19870215)59:4<675::aid-cncr2820590402>3.0.co;2-u. View

van Dongen J, Fentiman I, Harris J, Holland R, Peterse J, Salvadori B . In-situ breast cancer: the EORTC consensus meeting. Lancet. 1989; 2(8653):25-7. DOI: 10.1016/s0140-6736(89)90263-8. View

Solin L, Fowble B, Yeh I, Kowalyshyn M, Schultz D, Weiss M . Microinvasive ductal carcinoma of the breast treated with breast-conserving surgery and definitive irradiation. Int J Radiat Oncol Biol Phys. 1992; 23(5):961-8. DOI: 10.1016/0360-3016(92)90900-3. View

ROSNER D, Lane W, Penetrante R . Ductal carcinoma in situ with microinvasion. A curable entity using surgery alone without need for adjuvant therapy. Cancer. 1991; 67(6):1498-503. DOI: 10.1002/1097-0142(19910315)67:6<1498::aid-cncr2820670606>3.0.co;2-i. View

10.

OSTEEN R, Connolly J, Recht A, Silver B, Schnitt S, Harris J . Identification of patients at high risk for local recurrence after conservative surgery and radiation therapy for stage I or II breast cancer. Arch Surg. 1987; 122(11):1248-52. DOI: 10.1001/archsurg.1987.01400230034005. View

11.

Kurtz J, Jacquemier J, Amalric R, BRANDONE H, AYME Y, Hans D . Why are local recurrences after breast-conserving therapy more frequent in younger patients?. J Clin Oncol. 1990; 8(4):591-8. DOI: 10.1200/JCO.1990.8.4.591. View

12.

Eberlein T, Connolly J, Schnitt S, Recht A, OSTEEN R, Harris J . Predictors of local recurrence following conservative breast surgery and radiation therapy. The influence of tumor size. Arch Surg. 1990; 125(6):771-5; discussion 775-7. DOI: 10.1001/archsurg.1990.01410180097016. View

13.

Bartelink H, Borger J, van Dongen J, Peterse J . The impact of tumor size and histology on local control after breast-conserving therapy. Radiother Oncol. 1988; 11(4):297-303. DOI: 10.1016/0167-8140(88)90200-9. View

14.

Cabanes P, Salmon R, Vilcoq J, Durand J, Fourquet A, Gautier C . Value of axillary dissection in addition to lumpectomy and radiotherapy in early breast cancer. The Breast Carcinoma Collaborative Group of the Institut Curie. Lancet. 1992; 339(8804):1245-8. DOI: 10.1016/0140-6736(92)91591-u. View

15.

Recht A, Connolly J, Schnitt S, Silver B, Rose M, Love S . The effect of young age on tumor recurrence in the treated breast after conservative surgery and radiotherapy. Int J Radiat Oncol Biol Phys. 1988; 14(1):3-10. DOI: 10.1016/0360-3016(88)90043-0. View

16.

Kurtz J, Jacquemier J, Amalric R, BRANDONE H, AYME Y, Hans D . Risk factors for breast recurrence in premenopausal and postmenopausal patients with ductal cancers treated by conservation therapy. Cancer. 1990; 65(8):1867-78. DOI: 10.1002/1097-0142(19900415)65:8<1867::aid-cncr2820650833>3.0.co;2-i. View

17.

Holland R, Connolly J, Gelman R, Mravunac M, Hendriks J, Verbeek A . The presence of an extensive intraductal component following a limited excision correlates with prominent residual disease in the remainder of the breast. J Clin Oncol. 1990; 8(1):113-8. DOI: 10.1200/JCO.1990.8.1.113. View