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Open Access Highly Accessed Research article

Triple negativity and young age as prognostic factors in lymph node-negative invasive ductal carcinoma of 1 cm or less

Ji Hyun Kwon12, Yu Jung Kim1, Keun-Wook Lee1, Do-Youn Oh2, So Yeon Park3, Jee Hyun Kim1*, Eui Kyu Chie4, Sung-Won Kim5, Seock-Ah Im2, In-Ah Kim6, Tae-You Kim2, In Ae Park7, Dong-Young Noh8, Yung-Jue Bang2 and Sung Whan Ha4

Author Affiliations

1 Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

2 Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea

3 Department of Pathology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

4 Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea

5 Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

6 Department of Radiation Oncology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

7 Department of Pathology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea

8 Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea

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BMC Cancer 2010, 10:557  doi:10.1186/1471-2407-10-557

Published: 15 October 2010

Abstract

Background

Whether a systemic adjuvant treatment is needed is an area of controversy in patients with node-negative early breast cancer with tumor size of ≤1 cm, including T1mic.

Methods

We performed a retrospective analysis of clinical and pathology data of all consecutive patients with node-negative T1mic, T1a, and T1b invasive ductal carcinoma who received surgery between Jan 2000 and Dec 2006. The recurrence free survival (RFS) and risk factors for recurrence were identified.

Results

Out of 3889 patients diagnosed with breast cancer, 375 patients were enrolled (T1mic:120, T1a:93, T1b:162). Median age at diagnosis was 49. After a median follow up of 60.8 months, 12 patients developed recurrences (T1mic:4 (3.3%), T1a:2 (2.2%), T1b:6 (3.7%)), with a five-year cumulative RFS rate of 97.2%. Distant recurrence was identified in three patients. Age younger than 35 years (HR 4.91; 95% CI 1.014-23.763, p = 0.048) and triple negative disease (HR 4.93; 95% CI 1.312-18.519, p = 0.018) were significantly associated with a higher rate of recurrence. HER2 overexpression, Ki-67, and p53 status did not affect RFS.

Conclusions

Prognosis of node-negative breast cancer with T1mic, T1a and T1b is excellent, but patients under 35 years of age or with triple negative disease have a relatively high risk of recurrence.