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Small node-negative (T1b-cN0) invasive hormone receptor-positive breast cancers: Is there a subpopulation that might have benefit from adjuvant chemotherapy?

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Abstract

The aims of the study were to identify a subpopulation more likely to be at greater risk of recurrence in small T1b-c node-negative hormone receptor (HR)-positive breast cancer, and which would benefit from adjuvant chemotherapy. Clinico-pathologic characteristics and clinical outcomes of 538 postoperative HR-positive T1b-cN0 breast cancer patients were retrospectively analyzed. High Ki67 index and a young age (<35 years) were identified as independent risk factors for relapse (p < 0.0001 and 0.015, respectively). A nomogram based on Cox-regression model showed an area under the curve (AUC) of 0.73 in the training set. The validation set showed a good discrimination with an AUC of 0.65. In patients with high nomogram scores (≥100, n = 24, 4.5%) who had high Ki67 index with more than 75%, or young age (<35 years) and a Ki67 index >50%, the relapse-free survival curve of patients who had received anthracycline-containing adjuvant chemotherapy showed a better outcome than those who had not (p = 0.029). Ki67 index and age are valuable surrogate markers to predict recurrence and as indicators of tumors that could benefit from adjuvant chemotherapy in small T1b-c node-negative HR-positive breast cancer.

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Authors and Affiliations

  1. Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong Gangnam-gu, Seoul, 135-710, Korea

    Yeon Hee Park, Jin Seok Ahn & Young-Hyuck Im

  2. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea

    Seock-Ah Im

  3. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Eun Yoon Cho & Yoon-La Choi

  4. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Jeong Eon Lee, Seok Jin Nam & Jung Hyun Yang

  5. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

    Seock-Ah Im

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  1. Yeon Hee Park
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Park, Y.H., Im, SA., Cho, E.Y. et al. Small node-negative (T1b-cN0) invasive hormone receptor-positive breast cancers: Is there a subpopulation that might have benefit from adjuvant chemotherapy?. Breast Cancer Res Treat 133, 247–255 (2012). https://doi.org/10.1007/s10549-012-1956-1

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