The prognostic role of tumor size in early breast cancer in the era of molecular biology
The prognosis of early breast cancer (EBC) depends on patient and tumor characteristics. The association between tumor size, the largest diameter in TNM staging, and prognosis is well recognized. According to TNM, tumors classified as T2, could have very different volumes; e.g. a tumor of 2.1 cm has...
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| creator | Kasangian, Anaid Anna Gherardi, Giorgio Biagioli, Elena Torri, Valter Moretti, Anna Bernardin, Elena Cordovana, Andrea Farina, Gabriella Bramati, Annalisa Piva, Sheila Dazzani, Maria Chiara Paternò, Emanuela La Verde, Nicla Maria |
| description | The prognosis of early breast cancer (EBC) depends on patient and tumor characteristics. The association between tumor size, the largest diameter in TNM staging, and prognosis is well recognized. According to TNM, tumors classified as T2, could have very different volumes; e.g. a tumor of 2.1 cm has a volume of 4500 mm3, while a tumor of 4.9 cm has a volume of 60.000 mm3 even belonging to the same class. The aim of the study is to establish if the prognostic role of tumor size, expressed as diameter and volume, has been overshadowed by other factors.
The primary objective is to evaluate the association between tumor dimensions and overall survival (OS) / disease free survival (DFS), in our institution from January 1st 2005 to September 30th 2013 in a surgical T1-T2 population. Volume was evaluated with the measurement of three half-diameters of the tumor (a, b and c), and calculated using the following formula: 4/3π x a x b x c.
341 patients with T1-T2 EBC were included. 86.5% were treated with conservative surgery. 85.1% had a Luminal subtype, 9.1% were Triple negative and 7.4% were HER2 positive. Median volume was 942 mm3 (range 0.52-31.651.2). 44 patients (12.9%) relapsed and 23 patients died. With a median follow-up of 6.5 years, the univariate analysis for DFS showed an association between age, tumor size, volume, histological grading and molecular subtype. The multivariate analysis confirmed the statistically significant association only for molecular subtype (p 0.005), with a worse prognosis for Triple negative and HER2 positive subtypes compared with Luminal (HR: 2.65; 95%CI: 1.34-5.22). Likewise for OS, an association was shown by the multivariate analysis solely for molecular subtype (HER2 and Triple negative vs. Luminal. HR: 2.83; 95% CI:1.46-5.49; p 0.002).
In our study, the only parameter that strongly influences survival is molecular subtype. These findings encourage clinicians to choose adjuvant treatment not based on dimensional criteria but on biological features. |
| doi_str_mv | 10.1371/journal.pone.0189127 |
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The primary objective is to evaluate the association between tumor dimensions and overall survival (OS) / disease free survival (DFS), in our institution from January 1st 2005 to September 30th 2013 in a surgical T1-T2 population. Volume was evaluated with the measurement of three half-diameters of the tumor (a, b and c), and calculated using the following formula: 4/3π x a x b x c.
341 patients with T1-T2 EBC were included. 86.5% were treated with conservative surgery. 85.1% had a Luminal subtype, 9.1% were Triple negative and 7.4% were HER2 positive. Median volume was 942 mm3 (range 0.52-31.651.2). 44 patients (12.9%) relapsed and 23 patients died. With a median follow-up of 6.5 years, the univariate analysis for DFS showed an association between age, tumor size, volume, histological grading and molecular subtype. The multivariate analysis confirmed the statistically significant association only for molecular subtype (p 0.005), with a worse prognosis for Triple negative and HER2 positive subtypes compared with Luminal (HR: 2.65; 95%CI: 1.34-5.22). Likewise for OS, an association was shown by the multivariate analysis solely for molecular subtype (HER2 and Triple negative vs. Luminal. HR: 2.83; 95% CI:1.46-5.49; p 0.002).
In our study, the only parameter that strongly influences survival is molecular subtype. These findings encourage clinicians to choose adjuvant treatment not based on dimensional criteria but on biological features.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0189127</identifier><identifier>PMID: 29211792</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Analysis ; Biology and Life Sciences ; Biomedical research ; Breast cancer ; Cancer ; Cancer staging ; Cancer therapies ; Chemotherapy ; Classification ; Clinical medicine ; ErbB-2 protein ; Evaluation ; Gene amplification ; Genetic aspects ; Laboratories ; Mathematical analysis ; Medical prognosis ; Medicine and Health Sciences ; Metastasis ; Molecular biology ; Multivariate analysis ; Oncology ; Pathology ; Patients ; Prognosis ; Statistical analysis ; Surgery ; Survival ; Tumors</subject><ispartof>PloS one, 2017-12, Vol.12 (12), p.e0189127-e0189127</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Kasangian et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Kasangian et al 2017 Kasangian et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c653t-72211efefe736fc6e9cfe7c3f911e0c50b2bb5e72c3121d28e56e1d5a5893ae3</citedby><cites>FETCH-LOGICAL-c653t-72211efefe736fc6e9cfe7c3f911e0c50b2bb5e72c3121d28e56e1d5a5893ae3</cites><orcidid>0000-0002-6518-5734</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718505/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5718505/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79569,79570</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29211792$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kasangian, Anaid Anna</creatorcontrib><creatorcontrib>Gherardi, Giorgio</creatorcontrib><creatorcontrib>Biagioli, Elena</creatorcontrib><creatorcontrib>Torri, Valter</creatorcontrib><creatorcontrib>Moretti, Anna</creatorcontrib><creatorcontrib>Bernardin, Elena</creatorcontrib><creatorcontrib>Cordovana, Andrea</creatorcontrib><creatorcontrib>Farina, Gabriella</creatorcontrib><creatorcontrib>Bramati, Annalisa</creatorcontrib><creatorcontrib>Piva, Sheila</creatorcontrib><creatorcontrib>Dazzani, Maria Chiara</creatorcontrib><creatorcontrib>Paternò, Emanuela</creatorcontrib><creatorcontrib>La Verde, Nicla Maria</creatorcontrib><title>The prognostic role of tumor size in early breast cancer in the era of molecular biology</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The prognosis of early breast cancer (EBC) depends on patient and tumor characteristics. The association between tumor size, the largest diameter in TNM staging, and prognosis is well recognized. According to TNM, tumors classified as T2, could have very different volumes; e.g. a tumor of 2.1 cm has a volume of 4500 mm3, while a tumor of 4.9 cm has a volume of 60.000 mm3 even belonging to the same class. The aim of the study is to establish if the prognostic role of tumor size, expressed as diameter and volume, has been overshadowed by other factors.
The primary objective is to evaluate the association between tumor dimensions and overall survival (OS) / disease free survival (DFS), in our institution from January 1st 2005 to September 30th 2013 in a surgical T1-T2 population. Volume was evaluated with the measurement of three half-diameters of the tumor (a, b and c), and calculated using the following formula: 4/3π x a x b x c.
341 patients with T1-T2 EBC were included. 86.5% were treated with conservative surgery. 85.1% had a Luminal subtype, 9.1% were Triple negative and 7.4% were HER2 positive. Median volume was 942 mm3 (range 0.52-31.651.2). 44 patients (12.9%) relapsed and 23 patients died. With a median follow-up of 6.5 years, the univariate analysis for DFS showed an association between age, tumor size, volume, histological grading and molecular subtype. The multivariate analysis confirmed the statistically significant association only for molecular subtype (p 0.005), with a worse prognosis for Triple negative and HER2 positive subtypes compared with Luminal (HR: 2.65; 95%CI: 1.34-5.22). Likewise for OS, an association was shown by the multivariate analysis solely for molecular subtype (HER2 and Triple negative vs. Luminal. HR: 2.83; 95% CI:1.46-5.49; p 0.002).
In our study, the only parameter that strongly influences survival is molecular subtype. These findings encourage clinicians to choose adjuvant treatment not based on dimensional criteria but on biological features.</description><subject>Analysis</subject><subject>Biology and Life Sciences</subject><subject>Biomedical research</subject><subject>Breast cancer</subject><subject>Cancer</subject><subject>Cancer staging</subject><subject>Cancer therapies</subject><subject>Chemotherapy</subject><subject>Classification</subject><subject>Clinical medicine</subject><subject>ErbB-2 protein</subject><subject>Evaluation</subject><subject>Gene amplification</subject><subject>Genetic aspects</subject><subject>Laboratories</subject><subject>Mathematical analysis</subject><subject>Medical prognosis</subject><subject>Medicine and Health Sciences</subject><subject>Metastasis</subject><subject>Molecular biology</subject><subject>Multivariate analysis</subject><subject>Oncology</subject><subject>Pathology</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Statistical 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prognostic role of tumor size in early breast cancer in the era of molecular biology</title><author>Kasangian, Anaid Anna ; Gherardi, Giorgio ; Biagioli, Elena ; Torri, Valter ; Moretti, Anna ; Bernardin, Elena ; Cordovana, Andrea ; Farina, Gabriella ; Bramati, Annalisa ; Piva, Sheila ; Dazzani, Maria Chiara ; Paternò, Emanuela ; La Verde, Nicla Maria</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c653t-72211efefe736fc6e9cfe7c3f911e0c50b2bb5e72c3121d28e56e1d5a5893ae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Analysis</topic><topic>Biology and Life Sciences</topic><topic>Biomedical research</topic><topic>Breast cancer</topic><topic>Cancer</topic><topic>Cancer staging</topic><topic>Cancer therapies</topic><topic>Chemotherapy</topic><topic>Classification</topic><topic>Clinical medicine</topic><topic>ErbB-2 protein</topic><topic>Evaluation</topic><topic>Gene 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One</addtitle><date>2017-12-06</date><risdate>2017</risdate><volume>12</volume><issue>12</issue><spage>e0189127</spage><epage>e0189127</epage><pages>e0189127-e0189127</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The prognosis of early breast cancer (EBC) depends on patient and tumor characteristics. The association between tumor size, the largest diameter in TNM staging, and prognosis is well recognized. According to TNM, tumors classified as T2, could have very different volumes; e.g. a tumor of 2.1 cm has a volume of 4500 mm3, while a tumor of 4.9 cm has a volume of 60.000 mm3 even belonging to the same class. The aim of the study is to establish if the prognostic role of tumor size, expressed as diameter and volume, has been overshadowed by other factors.
The primary objective is to evaluate the association between tumor dimensions and overall survival (OS) / disease free survival (DFS), in our institution from January 1st 2005 to September 30th 2013 in a surgical T1-T2 population. Volume was evaluated with the measurement of three half-diameters of the tumor (a, b and c), and calculated using the following formula: 4/3π x a x b x c.
341 patients with T1-T2 EBC were included. 86.5% were treated with conservative surgery. 85.1% had a Luminal subtype, 9.1% were Triple negative and 7.4% were HER2 positive. Median volume was 942 mm3 (range 0.52-31.651.2). 44 patients (12.9%) relapsed and 23 patients died. With a median follow-up of 6.5 years, the univariate analysis for DFS showed an association between age, tumor size, volume, histological grading and molecular subtype. The multivariate analysis confirmed the statistically significant association only for molecular subtype (p 0.005), with a worse prognosis for Triple negative and HER2 positive subtypes compared with Luminal (HR: 2.65; 95%CI: 1.34-5.22). Likewise for OS, an association was shown by the multivariate analysis solely for molecular subtype (HER2 and Triple negative vs. Luminal. HR: 2.83; 95% CI:1.46-5.49; p 0.002).
In our study, the only parameter that strongly influences survival is molecular subtype. These findings encourage clinicians to choose adjuvant treatment not based on dimensional criteria but on biological features.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>29211792</pmid><doi>10.1371/journal.pone.0189127</doi><tpages>e0189127</tpages><orcidid>https://orcid.org/0000-0002-6518-5734</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
| recordid | cdi_plos_journals_1973446905 |
| source | DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Analysis Biology and Life Sciences Biomedical research Breast cancer Cancer Cancer staging Cancer therapies Chemotherapy Classification Clinical medicine ErbB-2 protein Evaluation Gene amplification Genetic aspects Laboratories Mathematical analysis Medical prognosis Medicine and Health Sciences Metastasis Molecular biology Multivariate analysis Oncology Pathology Patients Prognosis Statistical analysis Surgery Survival Tumors |
| title | The prognostic role of tumor size in early breast cancer in the era of molecular biology |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-15T14%3A40%3A12IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20prognostic%20role%20of%20tumor%20size%20in%20early%20breast%20cancer%20in%20the%20era%20of%20molecular%20biology&rft.jtitle=PloS%20one&rft.au=Kasangian,%20Anaid%20Anna&rft.date=2017-12-06&rft.volume=12&rft.issue=12&rft.spage=e0189127&rft.epage=e0189127&rft.pages=e0189127-e0189127&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0189127&rft_dat=%3Cgale_plos_%3EA517670480%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1973446905&rft_id=info:pmid/29211792&rft_galeid=A517670480&rft_doaj_id=oai_doaj_org_article_de6c3049fb174f01b8b85f088a62cf5b&rfr_iscdi=true |