Avoid common mistakes on your manuscript.
Dear Editor,
We read with great interest the article by Rask et al. [1] which analyzed the long-term results of small breast carcinomas (BC) according to molecular subtypes. Tissue samples from 445 women with node-negative BC ≤ 15 mm, treated in 1986–2004, were classified into surrogate molecular subtypes. They concluded that stage 1 TNBC or Luminal B-like (HER2-) tumors behave more aggressively and women with HER2 + /ER + tumors do not have an increased risk of distant metastasis or death, absent targeted treatment. Authors described the small tumors if tumor size is ≤ 15 mm. However, definition of small breas tumors are not strictly described in the literature. Furthermore, one study defined small tumors if tumor size is ≤ 10 mm (T1a, T1b) [2]. These descriptions are not concordant with TNM classification of the AJCC Breast Cancer Staging System. According to this guideline, small tumors are considered as all T1mi, a, b, c tumors. T1mi is a tumor that is 1 mm or smaller. T1a is a tumor that is larger than 1 mm but 5 mm or smaller. T1b is a tumor larger than 5 mm but 10 mm or smaller. T1c is a tumor larger than 10 mm but 20 mm or smaller [3]. In conlusion, the current study categorized ≤ 15 mm tumors as small tumors in their study. Their conclusion would not represent the outcome of all small tumors as described in TNM classification of the AJCC Breast Cancer Staging System. This issue merits further investigation.
Data availability
Not applicable.
References
Rask G, Nazemroaya A, Jansson M et al (2022) Correlation of tumour subtype with long-term outcome in small breast carcinomas: a Swedish population-based retrospective cohort study. Breast Cancer Res Treat. https://doi.org/10.1007/s10549-022-06691-4 (PMID: 35933487)
Tryfonidis K, Zardavas D, Cardoso F (2014) Small breast cancers: when and how to treat. Cancer Treat Rev 40(10):1129–1136. https://doi.org/10.1016/j.ctrv.2014.09.004
Giuliano AE, Edge SB, Hortobagyi GN (2018) Eighth edition of the AJCC cancer staging manual: breast cancer. Ann Surg Oncol 25(7):1783–1785. https://doi.org/10.1245/s10434-018-6486-6
Funding
No funding.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
We declare that I have no conflict of interest.
Ethical approval
Not applicable.
Informed consent
Not applicable.
Research involving in human and animal participant
This article does not contain any studies with human participants or animals performed by any of the authors.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Sanli, A.N., Altundag, K. Strict definition of a small tumor in breast cancer should be revisited. Breast Cancer Res Treat 196, 241 (2022). https://doi.org/10.1007/s10549-022-06734-w
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10549-022-06734-w