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Adjuvant chemotherapy of pT1a and pT1b breast carcinoma: results from the NEMESI study

Stefania Gori113*, Matteo Clavarezza2, Salvatore Siena3, Jennifer Foglietta1, Emiliana Tarenzi3, Monica Giordano4, Annamaria Molino5, Claudio Graiff6, Vittorio Fusco7, Oscar Alabiso8, Editta Baldini9, Teresa Gamucci10, Giuseppe Altavilla11, Davide Dondi12 and Marco Venturini2

Author affiliations

1 Oncologia Medica, Ospedale Santa Maria della Misericordia, Azienda Ospedaliera di Perugia, Perugia, Italy

2 Oncologia, Ospedale Sacro Cuore-Don Calabria, Negrar, (VR), Italy

3 Struttura Complessa di Oncologia Falck, Ospedale Niguarda Ca’ Granda, Milan, Italy

4 UO Oncologia, Azienda Ospedaliera Sant’Anna, Como, Italy

5 U.O.C. di Oncologia dell’Ospedale Civile Maggiore, Azienda Ospedaliera-Universitaria di Verona, Verona, Italy

6 Oncologia Medica, Ospedale di Bolzano, Bolzano, Italy

7 Oncologia, Azienda Ospedaliera di Alessandria, Alessandria, Italy

8 SC Oncologia, Azienda Ospedaliero-Universitaria “Maggiore della Carità”, Novara, Italy

9 Oncologia Medica, Ospedale Campo di Marte, Lucca, Italy

10 UO Oncologia Medica, Ospedale S.S. Trinità, Sora (FR), Sassari, Italy

11 Oncologia Medica, Università degli Studi Messina, Messina, Italy

12 Medical & Scientific Department, Sanofi-Aventis, Milan, Italy

13 Division of Medical Oncology, Ospedale S. Maria della Misericordia, Azienda Ospedaliera Perugia, via Dottori 1, Perugia, 06122, Italy

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Citation and License

BMC Cancer 2012, 12:158  doi:10.1186/1471-2407-12-158

Published: 30 April 2012



The prognosis of pT1a-pT1b breast cancer (BC) used to be considered very good, with a 10-y RFS of 90%. However, some retrospective studies reported a 10-y RFS of 81%–86% and suggested benefit from adjuvant systemic therapy.


To evaluate the variables that determined the choice of adjuvant chemotherapy and the type of chemotherapy delivered in pT1a-pT1b BC, we analysed the small tumours enrolled in the NEMESI study.


Out of 1,894 patients with pathological stage I-II BC enrolled in NEMESI, 402 (21.2%) were pT1a-pT1b. Adjuvant chemotherapy was delivered in 127/402 (31.59%). Younger age, grading G3, high proliferative index, ER-negative and HER2-positive status were significantly associated with the decision to administer adjuvant chemotherapy. An anthracycline without taxane regimen was administered in 59.1% of patients, anthracycline with taxane in 24.4%, a CMF-like regimen in 14.2% and taxane in 2.4%. Adjuvant chemotherapy was administered in 88.4% triple-negative and 73.46% HER2-positive pT1a-pT1b BC. Adjuvant trastuzumab was delivered in 30/49 HER2-positive BC (61.2%).


Adjuvant chemotherapy was delivered in 31.59% T1a-pT1b BC treated at 63 Italian oncological centres from January 2008 to June 2008. The choice to deliver chemotherapy was based on biological prognostic factors. Anthracycline-based chemotherapy was administered in 83.5% patients.

pT1a and pT1b breast cancer; Adjuvant chemotherapy; Adjuvant hormonal therapy