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Breast Cancer Research and Treatment

, Volume 163, Issue 1, pp 111–118 | Cite as

Management of small T1a/b breast cancer by tumor subtype

  • Tanja Ignatov
  • Holm Eggemann
  • Elke Burger
  • Serban Dan Costa
  • Atanas IgnatovEmail author
Clinical trial

Abstract

Background

The treatment of patients with small (T1a/b) breast cancer is based on retrospective analysis. The influence of intrinsic tumor subtypes on patients’ outcome and treatment decision remains unclear.

Patients and methods

This is a prospective cohort register study including 1008 patients with small T1a/b breast cancer treated between 2003 and 2011. Tumors were grouped by biological characteristics into four different subtypes: luminal A, luminal B, human epidermal growth factor receptor 2 (HER2)-enriched, and triple-negative breast cancer (TNBC).

Results

The median follow-up time was 6.5 years. From 919 eligible patients, 408 (44.4%) were classified as luminal A, 246 (26.8%) as luminal B, 183 (19.9%) as HER2 enriched, and 82 (8.9%) as TNBC. A total of 305 (34.2%) patients were treated with systemic therapy. Patients receiving systemic therapy were significantly younger and had lymph node metastasis, higher tumor grade, negative HR, and positive HER2 status. Patients with luminal A tumors demonstrated the best survival rate which improved with systemic therapy. The survival rate of patients with luminal B cancer, HER2-enriched tumors, and TNBC improved by addition of systemic treatment. The effect of systemic treatment was significant in luminal B (p = 0.040) and HER2 overexpressing tumors (p = 0.016). The treatment effect of systemic therapy in HER2-enriched tumors remained significant even after adjustment of other prognostic factors (HR 0.43, CI 0.19–0.98; p = 0.047). Notably, tumor size was not associated with patients’ survival and treatment decision.

Conclusion

The treatment decision of small breast cancer should be made by biological subtype and not by tumor size or lymph node status.

Keywords

T1/b Breast cancer Trastuzumab Chemotherapy HER2 

Notes

Funding

This research did not receive any specific grant from any funding agency in the public, commercial, or not-for-profit sector.

Compliance with ethical standards

Conflict of interest

The authors have no conflicts of interest.

Ethical standards

The experiments comply with the current laws of Germany and were performed according to the good clinical practice (GCP) guidelines.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Tanja Ignatov
    • 1
  • Holm Eggemann
    • 1
  • Elke Burger
    • 2
  • Serban Dan Costa
    • 1
  • Atanas Ignatov
    • 1
    Email author
  1. 1.Department of Obstetrics and GynecologyOtto-von-Guericke UniversityMagdeburgGermany
  2. 2.Institute of Biometry and Medical InformaticsOtto-von-Guericke UniversityMagdeburgGermany

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