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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2017

01-04-2017 | Breast Oncology

Chemotherapy Significantly Improves Survival for Patients with T1c-T2N0M0 Medullary Breast Cancer: 3739 Cases From the National Cancer Data Base

Authors: Alina M. Mateo, MD, Todd A. Pezzi, BS, Mark Sundermeyer, MD, Cynthia A. Kelley, MD, V. Suzanne Klimberg, MD, Christopher M. Pezzi, MD

Published in: Annals of Surgical Oncology | Issue 4/2017

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Abstract

Background

Medullary breast cancer (MBC) is a rare tumor associated with a better prognosis compared with other breast cancers. The role of adjuvant chemotherapy has not been extensively studied.

Methods

Female patients with invasive MBC reported to the National Cancer Data Base from 2004 to 2012 were analyzed. Overall survival (OS) and treatment were studied using the Kaplan–Meier method and the Cox proportional hazard model. Patients who had node-negative (N0), non-metastatic (M0) tumors 10 to 50 mm in size (T1cN0M0 and T2N0M0) treated with and without chemotherapy were analyzed using propensity score matching.

Results

Of 3739 patients with MBC, 2642 (71%) had T1b-T2N0M0 disease treated with and without chemotherapy. Multivariable analysis showed that for all MBC patients, the significant predictors of OS were age older than 65 years, one or more comorbidities, tumor larger than 2 cm, positive nodes, distant metastasis, and treatment with chemotherapy or radiation therapy. Patients with T1cN0M0 and T2N0M0 had improved OS if they received chemotherapy (p < 0.0005). Patients with T1bN0M0 who received chemotherapy did not show better OS than those who did not. Patients with T1c-T2N0M0 were then matched by propensity score based on age, presence of comorbidities, tumor size, and treatment methods used. After matching, the group receiving chemotherapy showed an improved OS (hazard ratio [HR], 0.40; 95% confidence interval [CI], 0.26–0.62; p < 0.0005) compared to the group that did not receive chemotherapy.

Conclusions

For patients with T1c-T2N0M0 MBC, chemotherapy significantly improves OS.
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Metadata
Title
Chemotherapy Significantly Improves Survival for Patients with T1c-T2N0M0 Medullary Breast Cancer: 3739 Cases From the National Cancer Data Base
Authors
Alina M. Mateo, MD
Todd A. Pezzi, BS
Mark Sundermeyer, MD
Cynthia A. Kelley, MD
V. Suzanne Klimberg, MD
Christopher M. Pezzi, MD
Publication date
01-04-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 4/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5649-6

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