Top

International Journal of Clinical Oncology

Published in:

01-08-2013 | Original Article

Is extracapsular tumour spread a prognostic factor in patients with early breast cancer?

Authors: Erion Dobi, Fernando Bazan, Armelle Dufresne, Martin Demarchi, Cristian Villanueva, Loic Chaigneau, Philipe Montcuquet, Arben Ivanaj, Jean Loup Sautière, Yolande Maisonnette-Escot, Laurent Cals, Marie Paule Algros, Anne-Sophie Woronoff, Xavier Pivot

Published in: International Journal of Clinical Oncology | Issue 4/2013

Abstract

Background

This study searched for extra capsular tumour spread (ECS) as a prognostic factor for recurrence in terms of Disease Free Survival (DFS) and Overall Survival (OS).

Patients and methods

For this study, from a retrospective database of the Doubs cancer registry, 823 eligible women with node positive breast cancer treated from February 1984 to November 2000 were identified. The following factors were evaluated: ECS, numbers of involved nodes, histological tumour grade, tumour size, status of estrogen and progesterone receptors, and age of patient. A Cox proportional hazards method was used to search for significant factors related to OS and DFS length.

Results

In the multivariate analysis, factors related to DFS length were found to be: tumour grade (aHR 0.76, 95 % CI 0.61–0.96, p = 0.02), ECS status (aHR 0.7, 95 % CI 0.49–0.96, p = 0.03), progesterone (PgR) status (aHR 0.63, 95 % CI 0.44–0.85 p = 0.008), number of nodes involved (aHR 0.75, 95 % CI 0.56–1, p = 0.05). The multivariate analysis for OS found as significant factors: tumour grade (aHR 0.76, 95 % CI 0.61–0.95; p = 0.02) and PgR status (aHR 0.8, 95 % CI 0.56–0.99, p = 0.02).

Conclusions

This study might suggest taking into account ECS status in the adjuvant decision-making process.

Zhou P, Recht A (2004) Young age and outcome for women with early-stage invasive breast cancer. Cancer 101:1264–1274PubMedCrossRef

Rondeau V, Mathoulin-Pélissier S, Tanneau L et al (2010) Separate and combined analysis of successive dependent outcomes after breast-conservation surgery: recurrence, metastases, second cancer and death. BMC Cancer 10:697–706PubMedCrossRef

Berg JW, Robbins GF (1966) Factors influencing the short and the long-term survival of breast cancer patients. Surg Gynecol Obstet 122:1311–1336PubMed

Katz A, Strom EA, Buchholz TA et al (2000) Locoregional recurrence patterns after mastectomy and doxorubicin-based chemotherapy: implications for postoperative irradiation. J Clin Oncol 18:2817–2827PubMed

Gruber G, Bonetti M, Nasi ML et al (2005) Prognostic value of extracapsular tumour spread for locoregional control in premenopausal patients with node-positive breast cancer treated with classical cyclophosphamide, methotrexate, and fluorouracil: long-term observations from International Breast Cancer Study Group Trial VI. J Clin Oncol 23:7089–7097PubMedCrossRef

Fisher BJ, Perera FE, Cooke AL et al (1997) Extracapsular axillary node extension in patients receiving adjuvant systemic therapy: an indication for radiotherapy? Int J Radiat Oncol Biol Phys 38:551–559PubMedCrossRef

Kahlert S, Boettcher B, Lebeau A, et al. (1999) Prognostic impact of extended extracapsular component in involved lymph nodes in primary breast cancer. Eur J Cancer 35:S89, (Abstr 292)

Leonard C, Corkill M, Tomkin J et al (1995) Are axillary recurrence and overall survival affected by axillary extranodal tumour extension in breast cancer? Implications for radiation therapy. J Clin Oncol 13:47–53PubMed

Ragaz J, Jackson SM, Le N et al (1997) Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer. N Engl J Med 337:956–962PubMedCrossRef

10.

Hetelekidis S, Schnitt SJ, Silver B et al (2000) The significance of extracapsular extension of axillary lymph node metastases in early-stage breast cancer. Int J Radiat Oncol Biol Phys 46:31–34PubMedCrossRef

11.

Veronesi U, Rilke F, Luini A et al (1987) Distribution of axillary node metastases by level of invasion: an analysis of 539 cases. Cancer 59:682–687PubMedCrossRef

12.

Pierce LJ, Oberman HA, Strawderman MH et al (1995) Microscopic extracapsular extension in the axilla: is this an indication for axillary radiotherapy? Int J Radiat Oncol Biol Phys 33:253–259PubMedCrossRef

13.

Vicini FA, Horwitz EM, Lacerna MD et al (1997) The role of regional nodal irradiation in the management of patients with early-stage breast cancer treated with breast-conserving therapy. Int J Radiat Oncol Biol Phys 39:1069–1076PubMedCrossRef

14.

Fodor J, Toth J, Major T et al (1999) Incidence and time of occurrence of regional recurrence in stage I-II breast cancer: value of adjuvant irradiation. Int J Radiat Oncol Biol Phys 44:281–287PubMedCrossRef

15.

Jager JJ, Volovics L, Schouten LJ et al (1999) Loco-regional recurrences after mastectomy in breast cancer: prognostic factors and implications for postoperative irradiation. Radiother Oncol 50:267–275PubMedCrossRef

16.

Gruber G, Menzi S, Forster A et al (2005) Sites of failure in breast cancer patients with extracapsular invasion of axillary lymph node metastases, no need for axillary irradiation?! Strahenther Onkol 181:574–579CrossRef

17.

Fisher ER, Palekar AS, Gregorio RM et al (1976) Pathologic findings from the National Surgical Adjuvant Breast Project (protocol No. 4), III: the significance of extranodal extension of axillary metastases. Am J Clin Pathol 65:439–444PubMed

18.

Mambo NC, Gallager S (1977) Carcinoma of the breast: the prognostic significance of extranodal extension of axillary disease. Cancer 39:2280–2285PubMedCrossRef

19.

Greene FL, Page DL, Fleming ID et al (2002) A.J.C.C. Cancer Staging Mannual, 6th ed. Springer, New York, pp 72–73

20.

Kaplan E, Meier P (1958) Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457–481CrossRef

21.

Cox DR (1972) Regression models and lifetables. J R Stat Soc B 34:187–220

22.

Brewster AM, Do KA, Thomson PA et al (2007) Relationship between epidemiologic risk factor and breast cancer recurrence. J Clin Oncol 25:4438–4444PubMedCrossRef

23.

Marchionni L, Wilson RF, Marinopoulos SS et al (2007) Impact of gene expression profiling tests on breast cancer outcomes. Evid Rep Technol Assess 160:1–105

24.

Bucci JA, Kennedy CW, Burn J et al (2001) Implications of extranodal spread in node positive breast cancer: a review of survival and local recurrence. Breast 10:213–219PubMedCrossRef

25.

Brenner B, Siris S, Rakowsky E et al (2002) Prediction of outcome in locally advanced breast cancer by post-chemotherapy nodal status and baseline tumour markers. Br J Cancer 87:1404–1410PubMedCrossRef

26.

Neri A, Marrelli D, Roviello F et al (2005) Prognostic value of extracapsular extension of axillary lymph node metastases in T1 to T3 breast cancer. Ann Surg Oncol 12:246–253PubMedCrossRef

27.

Gruber G, Cole B, Castiglione-Gertsch M et al (2008) Extracapsular tumour spread and the risk of local, axillary and supraclavicular recurrence in node positive, premenopausal patients with breast cancer. Anals Oncology 19:1393–1401CrossRef

28.

Ceilley E, Jagsi R, Goldberg S (2005) Radiotherapy for invasive breast cancer in North America and Europe: results of a survey. Int J Radiat Oncol Biol Phys 61:365–373PubMedCrossRef

29.

Overgaard M, Hansen PS, Overgaard J et al (1997) Postoperative radiotherapy in high risk premenopausal women with breast cancer who receive adjuvant chemotherapy: Danish Breast Cancer Cooperative Group 82b Trial. N Engl J Med 337:949–955PubMedCrossRef

30.

Overgaard M, Jensen MB, Overgaard J et al (1999) Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen: Danish Breast Cancer Cooperative Group DBCG 82c randomised trial. Lancet 353:1641–1648PubMedCrossRef

31.

Van den Eynden G, Vandenberghe M, Van Dam P et al (2007) Increased sentinel lymph node lymphangiogenesis is associated with nonsentinel axillary node involvement in breast cancer patients with a positive sentinel node. Clin Cancer Res 13:5391–5397PubMedCrossRef

Title: Is extracapsular tumour spread a prognostic factor in patients with early breast cancer?
Authors: Erion Dobi
Fernando Bazan
Armelle Dufresne
Martin Demarchi
Cristian Villanueva
Loic Chaigneau
Philipe Montcuquet
Arben Ivanaj
Jean Loup Sautière
Yolande Maisonnette-Escot
Laurent Cals
Marie Paule Algros
Anne-Sophie Woronoff
Xavier Pivot
Publication date: 01-08-2013
Publisher: Springer Japan
Published in: International Journal of Clinical Oncology / Issue 4/2013
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-012-0439-z

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 4/2013

Treatment outcome of patients with extragonadal nonseminomatous germ cell tumors: the Saitama Cancer Center experience

Chemotherapy with bevacizumab for metastatic colorectal cancer: a retrospective review of 181 Japanese patients

Clinical usefulness of KRAS, BRAF, and PIK3CA mutations as predictive markers of cetuximab efficacy in irinotecan- and oxaliplatin-refractory Japanese patients with metastatic colorectal cancer

Influence of a multidisciplinary cancer board on treatment decisions

Weekly low-dose docetaxel combined with estramustine and dexamethasone for Japanese patients with metastatic castration-resistant prostate cancer

Recent advances in reconstructive surgery: head and neck reconstruction

Keynote webinar | Spotlight on antibody–drug conjugates in cancer