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Annals of Surgical Oncology

, Volume 20, Issue 3, pp 811–818 | Cite as

Microinvasive Breast Cancer: ER, PR, and HER-2/neu Status and Clinical Outcomes after Breast-Conserving Therapy or Mastectomy

  • Danielle N. Margalit
  • Meera Sreedhara
  • Yu-Hui Chen
  • Paul J. Catalano
  • Paul L. Nguyen
  • Mehra Golshan
  • Beth A. Overmoyer
  • Jay R. Harris
  • Jane E. Brock
Breast Oncology

Abstract

Background

Contemporary clinical outcomes of microinvasive breast cancer (MIBC), defined as no focus >1 mm, are not well characterized. We document the immunophenotype, incidence of axillary metastases, and rate of recurrence in a well-defined case series.

Methods

We reviewed 83 consecutive patients with MIBC from 1997 to 2005. Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER-2/neu) receptor status were assessed. The cumulative incidence of local recurrence (LR) and nodal/distant recurrence was calculated. Predictors of recurrence were identified and effect estimates determined.

Results

Fifty-two patients (63 %) underwent breast-conserving therapy (BCT) and 31 (37 %) underwent mastectomy. Sixty-one percent had ER-positive disease and 49 % had HER-2/neu-positive disease. Three (4 %) of 68 patients with sentinel node mapping or axillary dissection had single node micrometastases, and none had macrometastases or multiple nodes involved. Median follow-up was 6.4 years, with 6 LRs, 2 regional nodal recurrences, and 2 concurrent local/distant recurrences. The 5-year cumulative incidence of recurrence (local, nodal, or distant) was 5.3 % (95 % confidence interval [CI] 2.0–13.4) for all patients, and among BCT patients, the 5-year cumulative incidence of LR was 4.2 % (95 % CI 0.7–12.7). HER-2/neu overexpression was not associated with recurrence (P = 0.46). Close/positive margins (≤2 mm) were significantly associated with an increased risk of LR after BCT or mastectomy (hazard ratio 8.8; 95 % CI 1.6–48.8; P = 0.003).

Conclusions

MIBC has a favorable prognosis, and HER-2/neu overexpression, although highly prevalent, is not significantly associated with recurrence. Axillary metastases at diagnosis are small and infrequent. The cumulative incidence of LR after BCT is acceptable; however, our data confirm that negative margins (>2 mm) are required for optimal BCT outcomes.

Keywords

Estrogen Receptor Local Recurrence Progesterone Receptor Human Epidermal Growth Factor Receptor Distant Recurrence 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

We thank Barbara Silver for editing and research support.

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Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Danielle N. Margalit
    • 1
  • Meera Sreedhara
    • 1
  • Yu-Hui Chen
    • 2
  • Paul J. Catalano
    • 2
  • Paul L. Nguyen
    • 1
  • Mehra Golshan
    • 3
  • Beth A. Overmoyer
    • 4
  • Jay R. Harris
    • 1
  • Jane E. Brock
    • 5
  1. 1.Department of Radiation OncologyBrigham & Women’s Hospital/Dana-Farber Cancer InstituteBostonUSA
  2. 2.Harvard Cancer ConsortiumBrigham & Women’s Hospital/Dana-Farber Cancer InstituteBostonUSA
  3. 3.Department of SurgeryBrigham & Women’s Hospital/Dana-Farber Cancer InstituteBostonUSA
  4. 4.Department of Medical OncologyBrigham & Women’s Hospital/Dana-Farber Cancer InstituteBostonUSA
  5. 5.Department of PathologyBrigham & Women’s Hospital/Dana-Farber Cancer InstituteBostonUSA

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