Skip to main content

Advertisement

SpringerLink
Log in

Immunohistochemically defined subtypes and outcome in occult breast carcinoma with axillary presentation

  • Clinical Trial
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

The aim of this study is to evaluate the outcome of occult breast cancer (OBC) in patients with axillary presentation overall and according to the immunohistochemically defined tumour subtypes. We reviewed information on 15,490 consecutive primary breast cancer patients, who underwent surgery at the European institute of oncology between September 1997 and December 2008. Patients with OBC were compared with an equal number of patients with small invasive breast carcinomas (pT1) observed at the same institution during the same period, matched for year of surgery, age, nodal status and biological features. Eighty patients with OBC (study group) and 80 patients with early breast cancer (control group) were identified. There was no significant difference in the disease-free survival (5 years DFS 66 vs. 68% P = 0.91) and the overall survival (5 years OS 80 and 86% P = 0.99) between the OBC and control groups. A statistically significant worse outcome was observed within the group of OBC for patients with more than four involved lymph nodes and with triple negative tumours. The outcome of OBC patients is comparable with that of matched patients with small sized breast cancer. High risk of relapse and death was observed in OBC patients with triple negative tumours and extensive nodal involvement.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Vilcoq JR, Calle R, Ferme F et al (1982) Conservative treatment of axillary adenopathy due to a probable subclinical breast cancer. Arch Surg 117:1136–1138

    PubMed  CAS  Google Scholar 

  2. Owen HW, Dockerty MB, Gray HK (1954) Occult carcinoma of the breast. Surg Gynecol Obstet 98:302–308

    PubMed  CAS  Google Scholar 

  3. Galimberti V, Bassani G, Monti S et al (2004) Clinical experience with axillary presentation breast cancer. Br Can Res and Treat 88:43–47

    Article  Google Scholar 

  4. Newman LA, Singletary SE (2007) Overview of adjuvant systemic therapy in early stage breast cancer. Surg Clin North Am 87:499–509

    Article  PubMed  Google Scholar 

  5. Vezzoni P, Balestrazzi A, Bignami P et al (1979) Axillary lymph node metastases from occult carcinoma of the breast. Tumori 65:87–91

    PubMed  CAS  Google Scholar 

  6. Rosen PP, Kimmel M (1990) Occult breast carcinoma presenting with axillary lymph node metastases. A follow-up study of 48 patients. Hum Pathol 21:518–524

    Article  PubMed  CAS  Google Scholar 

  7. Merson M, Andreola S, Galimberi V et al (1992) Breast carcinoma presenting as axillary metastases without evidence of a primary tumour. Cancer 70:504–508

    Article  PubMed  CAS  Google Scholar 

  8. Kyokane T, Akashi-Tanaka S, Matsui T et al (1995) Clinicopathological characteristics of non-palpable breast cancer presenting as an axillary mass. Breast Cancer 2:105–112

    Article  PubMed  Google Scholar 

  9. Perou CM, Sorlie T, Eisen MB et al (2000) Molecular portraits of human breast tumours. Nature 406(6797):747–752

    Article  PubMed  CAS  Google Scholar 

  10. de Ronde JJ, Hannemann J, Halfwerk H et al (2010) Concordance of clinical and molecular breast cancer subtyping in the context of preoperative chemotherapy response. Breast Cancer Res Treat 119(1):119–126

    Article  PubMed  Google Scholar 

  11. Cheang MC, Chia SK, Voduc D et al (2009) Ki67 Index, HER2 status, and prognosis of patients with Luminal B breast cancer. J Natl Cancer Inst 101(10):736–750

    Article  PubMed  CAS  Google Scholar 

  12. Hugh J, Hanson J, Cheang MC et al (2009) Breast cancer subtypes and response to docetaxel in node-positive breast cancer: use of an immunohistochemical definition in the BCIRG 001 trial. J Clin Oncol 27:1168–1176

    Article  PubMed  CAS  Google Scholar 

  13. Cancello G, Maisonneuve P, Rotmensz N et al (2010) Prognosis and adjuvant treatment effects in selected breast cancer subtypes of very young women (<35 years) with operable breast cancer. Ann Oncol 21:1974–1981

    Article  PubMed  CAS  Google Scholar 

  14. Colleoni M, Cole BF, Viale G et al (2010) Classical cyclophosphamide, methotrexate, and fluorouracil chemotherapy is more effective in triple-negative, node-negative breast cancer: results from two randomized trials of adjuvant chemoendocrine therapy for node-negative breast cancer. J Clin Oncol 28(18):2966–2973

    Article  PubMed  CAS  Google Scholar 

  15. Colleoni M, Orvieto E, Nolè F et al (1999) Prediction of response to primary chemotherapy for operable breast cancer. Eur J Cancer 35:574–579

    Article  PubMed  CAS  Google Scholar 

  16. Kalbfleisch JD, Prentice RL (1980) The statistical analysis of failure time data. Wiley, San Francisco

    Google Scholar 

  17. Gray RJ (1988) A class of K-sample tests for comparing the cumulative incidence of a competing risk. Ann Statist 16:1141–1154

    Article  Google Scholar 

  18. Svastics E, Ronay P, Bodo M (1993) Occult breast cancer presenting with axillary metastasis. Eur J Surg Oncol 19 (Suppl 1):575–580

    PubMed  CAS  Google Scholar 

  19. Jackson B, Scot-Conner C, Moulder J (1995) Axillary metastasis from occult breast carcinoma: diagnosis and management. Am Surg 61:431–434

    PubMed  CAS  Google Scholar 

  20. Pentheroudakis G, Lazaridis G, Pavlidis N (2010) Axillary nodal metastases from carcinoma of unknown primary (CUPAx): a systematic review of published evidence. Breast Cancer Res Treat 119:1–11

    Article  PubMed  Google Scholar 

  21. Panoff JE, Hurley J, Takita C et al (2011) Risk of locoregional recurrence by receptor status in breast cancer patients receiving modern systemic therapy and post-mastectomy radiation. Breast Cancer Res Treat 899–906

  22. Dent R, Trudeau M, Pritchard KI et al (2007) Triple negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res 13(15 Pt 1):4429–4434

    Article  PubMed  Google Scholar 

  23. Bassarova AV, Nesland JM, Sedloev T et al (2005) Simultaneous bilateral breast carcinomas: a category with frequent coexpression of HER-2 and ER-alpha, high Ki-67 and bcl-2, and low p53. Int J Surg Pathol 13(3):239–240

    Article  PubMed  CAS  Google Scholar 

  24. Tanner M, Järvinen P, Isola J (2001) Amplification of HER-2/neu and topoisomerase IIalpha in primary and metastatic breast cancer. Cancer Res 15 61(14):5345–5348

    CAS  Google Scholar 

  25. Iguchi C, Nio Y, Itakura M et al (2003) Heterogenic expression of oestrogen receptor between the primary tumour and the corresponding involved lymph nodes in patients with node-positive breast cancer and its implications in patient outcome. J Surg Oncol 83:85–93

    Article  PubMed  CAS  Google Scholar 

  26. Kamby C, Rasmussen BB, Kristensen B et al (1989) Oestrogen receptor status of primary breast carcinomas and their metastases. Relation to pattern of spread and survival after recurrence. Br J Cancer 60:252–257

    Article  PubMed  CAS  Google Scholar 

  27. Goldhirsch A, Glick JH, Gelber RD et al (1998) Meeting highlights: International Consensus Panel on the Treatment of Primary Breast Cancer. J Natl Cancer Inst 90:1601–1608

    Article  PubMed  CAS  Google Scholar 

  28. Goldhirsch A, Ingle JN, Gleber RD et al (2009) Thresholds for therapies: highlights of the St Gallen International expert consensus on the primary therapy of early breast cancer. Ann Oncol 20(8):1319–1329

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Medical Oncology, Department of Medicine, Unit Research of Medical Senology, European Institute of Oncology, Via Ripamonti 435, 20141, Milan, Italy

    Emilia Montagna, Giuseppe Cancello, Manuelita Mazza, Anna Cardillo, Raffaella Ghisini, Aron Goldhirsch & Marco Colleoni

  2. Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy

    Vincenzo Bagnardi & Nicole Rotmensz

  3. Department of Statistics, University of Milan-Bicocca, Milan, Italy

    Vincenzo Bagnardi

  4. Frontier Science and Technology Research Foundation Southern Europe, Chiasso, Switzerland

    Vincenzo Bagnardi

  5. University of Milan School of Medicine, Milan, Italy

    Giuseppe Viale & Paolo Veronesi

  6. Division of Pathology, European Institute of Oncology, Milan, Italy

    Giuseppe Viale, Paola Rafaniello Raviele & Mauro Giuseppe Mastropasqua

  7. Division of Senology, European Institute of Oncology, Milan, Italy

    Viviana Galimberti, Paolo Veronesi, Simonetta Monti & Alberto Luini

Authors
  1. Emilia Montagna
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vincenzo Bagnardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nicole Rotmensz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Giuseppe Viale
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Giuseppe Cancello
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Manuelita Mazza
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Anna Cardillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Raffaella Ghisini
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Viviana Galimberti
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Paolo Veronesi
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Simonetta Monti
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Alberto Luini
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Paola Rafaniello Raviele
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Mauro Giuseppe Mastropasqua
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Aron Goldhirsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Marco Colleoni
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Emilia Montagna.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Montagna, E., Bagnardi, V., Rotmensz, N. et al. Immunohistochemically defined subtypes and outcome in occult breast carcinoma with axillary presentation. Breast Cancer Res Treat 129, 867–875 (2011). https://doi.org/10.1007/s10549-011-1697-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-011-1697-6

Keywords

Search

Navigation