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Medline ® Abstract for Reference 44

of 'Pathology of breast cancer'

Outcome after breast-conserving therapy for patients with stage I or II mucinous, medullary, or tubular breast carcinoma.
Thurman SA, Schnitt SJ, Connolly JL, Gelman R, Silver B, Harris JR, Recht A
Int J Radiat Oncol Biol Phys. 2004;59(1):152.
PURPOSE: To evaluate the site of first failure of patients with early-stage tubular, mucinous, and medullary breast carcinoma after breast-conserving therapy and compare their results with those of patients with infiltrating ductal carcinoma (IDC).
METHODS AND MATERIALS: Twenty clinical Stage I and II patients with mucinous carcinoma, 27 with medullary carcinoma, 28 with tubular carcinoma, and 1055 with IDC were identified. The minimal potential follow-up was 10 years.
RESULTS: No statistically significant difference (p = 0.15) was seen in the site of first failure between the four histologic types within the first 10 years after treatment. When the IDC tumors were omitted from the comparison, the failure patterns of the remaining three histologic types were not significantly different (p = 0.31). In a polychotomous logistic model, histologic type was not significantly associated with the site of first failure (all p>0.17). Local failure was significantly associated with age<50 years (p = 0.04), positive surgical margins (p =0.007), lymphovascular invasion (p = 0.04), and tumors with an extensive intraductal component (p<0.001). Regional/distant/opposite breast failure was significantly associated with clinical Stage T2 tumors (p<0.001), four or more positive lymph nodes (p = 0.004), and lymphovascular invasion-positive tumors (p<0.001). Second malignancy or death was significantly associated with age at diagnosis>60 years (p<0.001) and lymphovascular invasion-positive tumors (p = 0.03).
CONCLUSION: No statistically significant difference was noted in the site of first failure between patients with medullary, mucinous, or tubular carcinoma and patients with IDC. Although not statistically significant, we did note a trend toward a lower long-term rate of disease-free survival in patients with IDC.
Department of Radiation Oncology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. sthurman@caregroup.harvard.edu