STAGE I BREAST CANCER: PATHOLOGICAL CHARACTERISTICS and CLINIC RESULTS

Increased public awareness and large scaled screening programs has led to detection of breast cancer at rather earlier stages worldwide. Among early stage breast cancer patients, those with pT1N0 tumors were reported to have a very favorable 5-10 year survival. We reviewed the clinical records of stage I breast cancer (BC) patients who have been followed in our clinic between 1997-2003, recorded their clinical and pathological characteristics and also analysed their clinical outcome. A total of 66 breast cancer patients with pT1N0 disease and at least 10 months of follow up were identified. The median age was 48 (33-83) and the median follow up was 40 (10-78) months. Majority of patients were postmenopausal (52 %) and >35 years of age (96 %). Fifty peecent of patients had breast conserving surgery. Forty-eight (73 %) patients had grade 2-3 tumors. The tumor histology was invasive ductal carcinoma in 84 % patients and 15 (23 %) patients had both receptors negative by immunhistochemistry. Median number of dissected axillary lymph nodes (ALN) was 14 (1-41) and 10 (16 %) patients had (10 ALN dissected. Among 66 patients, two paients (3 %) had T1a, 13 (20 %) had T1b and 51 (77 %) had T1c tumors. All patients received some form of adjuvant systemic therapy (chemotherapy or endocrine therapy or both). The 5 year DFS was found to be 97 %, consistent with the data in the literature. However, our data is not mature to analyse neither the survival nor the prognostic impact of clinical/pathologic factors on overall and disease free survival. Despite very few in number, there were patients (n=2) with relapse. Prognostic factors that influnece the behavior of T1N0 breast cancer need to be investigated in the context of large scaled prospective translational and/or clinical trials in order to reliably distinguish those patients who deserve some form of adjuvant systemic therapy and those whose prognosis is sufficiently good to neglect the small benefit provided by adjuvant systemic therapy.