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Medline ® Abstract for Reference 41

of 'Prognostic and predictive factors in early, nonmetastatic breast cancer'

Tumor size is an unreliable predictor of prognosis in basal-like breast cancers and does not correlate closely with lymph node status.
Foulkes WD, Grainge MJ, Rakha EA, Green AR, Ellis IO
Breast Cancer Res Treat. 2009 Sep;117(1):199-204. Epub 2008 Jul 4.
Larger breast tumors tend to be associated with a greater number of axillary lymph nodes involved with metastatic tumor than are smaller tumors. This rule may not fully apply in BRCA1-related breast cancers. We hypothesized that the rule also might not apply in basal-like breast cancers (BLBC), and further, that disruption of this relationship would impact on prognosis. In 1,324 non-BLBC (87.1% of 1520 tumors), after adjustment for grade, a strongly positive correlation between increasing tumor size and increasing number of lymph nodes involved by tumor was observed (P for trend<.001). The correlation was much weaker in 196 BLBC (12.9%) (P for trend = 0.58). Similarly, a worsening breast cancer-specific survival with increasing tumor size was observed in non-BLBC (P for trend<.001) but not in BLBC (P for trend = 0.43). The "size-nodes" relationship in BLBC is distinct and is similar to that seen in BRCA1-related breast cancer, further suggesting biological similarities between these sub-types of breast cancer. Moreover, tumor size is not a strong indicator of prognosis in BLBC.
Departments of Oncology and Human Genetics, McGill University, Montreal, QC, Canada. william.foulkes@mcgill.ca