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Tumor size is an unreliable predictor of prognosis in basal-like breast cancers and does not correlate closely with lymph node status

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Abstract

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.

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Acknowledgments

We would like to thank Jean-Sébastien Brunet for advice. Andrew Green is funded by the Breast Cancer Campaign and William Foulkes is funded by the Canadian Breast Cancer Research Alliance.

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Authors and Affiliations

  1. Program in Cancer Genetics, Departments of Oncology and Human Genetics, McGill University, 546 Pine Ave West, Montreal, QC, Canada, H2W 126

    William D. Foulkes

  2. Division of Epidemiology and Public Health, School of Community Health Sciences, University of Nottingham, Queen’s Medical Centre Campus, Nottingham, NG7 2UH, UK

    Matthew J. Grainge

  3. School of Molecular Medical Sciences, University of Nottingham, Queen’s Medical Centre Campus, Nottingham, NG7 2UH, UK

    Emad A. Rakha, Andrew R. Green & Ian O. Ellis

  4. Department of Histopathology, Nottingham Universities Hospital NHS Trust, City Hospital Campus, Hucknall Road, NG5 1PB, Nottingham, UK

    Emad A. Rakha & Ian O. Ellis

Authors
  1. William D. Foulkes
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  2. Matthew J. Grainge
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  3. Emad A. Rakha
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  4. Andrew R. Green
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  5. Ian O. Ellis
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Correspondence to William D. Foulkes.

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Foulkes, W.D., Grainge, M.J., Rakha, E.A. et al. Tumor size is an unreliable predictor of prognosis in basal-like breast cancers and does not correlate closely with lymph node status. Breast Cancer Res Treat 117, 199–204 (2009). https://doi.org/10.1007/s10549-008-0102-6

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  • DOI: https://doi.org/10.1007/s10549-008-0102-6

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