Paget's Information from SABCS abstract
P6-07-42
Patients with Nipple-areola Paget’s Disease and Underlying Invasive Breast Carcinoma had a Very Poor Survival: a Matched Cohort Study Ling H, Xu X-L, Liu Z-B, Shao Z-M. Fudan University Shanghai Cancer Center, Shanghai, China [Purpose] Nipple-areola Paget’s disease together with invasive breast cancer is a rare kind of disease. This study is to investigate the characteristic and survival of it. [Patients] From 2001 to 2005, all patients diagnosed as nipple-areola Paget’s disease with underlying invasive breast carcinoma in Fudan University Shanghai Cancer Center (FUSCC) were recruited in this study (PD group). www.aacrjournals.org 531s Cancer Res; 72(24 Suppl.) December 15, 2012 December 4-8, 2012 Abstracts: General Session 6 Patients diagnosed as invasive breast cancer without Paget’s disease were recruited in control group for clinical and pathologic features comparison. Since tumors in PD group expressed more high risk factors (see results), a matched study was done to investigate whether the poor survival of PD group was by nature or due to the overexpression of high risk factors. The matched group was derived from all the patients who received mastectomy for invasive breast cancer (with no Paget’s disease) during 2001 to 2005 in FUSCC. The match was conducted according to four variables: dimension of tumor, lymph node status, hormone receptor status and Her2 status. After matching, patients were randomly selected in a 3:1 ratio to patients in PD group. [Results] 52 patients were recruited in PD group. 22 (42.3%) patients’ primary symptom were nipple change, 25 (48.1%) patients’ primary symptom were mass in breast. Physical examination found no nipple-areola change in 24 patients at diagnosis, their Paget’s disease were found unexpectedly by routine nipple-areola section examination after mastectomy. More than 8000 invasive breast cancers were diagnosed during 2001 to 2005. 700 patients (140 consecutive patients per year, average monthly patient amount) were recruited in control group. Compared with control group, tumors in PD group had larger size, more axillary lymph node involvement, lower hormone receptor expression, higher HER2 expression and worse survival. Comparison of Pathologic Features (Control Group) and Survival (Matched Group) with PD Group PD group (n=52) Control Group (n=700) Matched Group (n=156) Dimension ≤2cm 24 (46.2%) 423 (60.4%)∗ 72 (46.2%) >2cm 28 (53.8%) 277 (39.6%) 84 (53.8%) Lymph Node + 28 (53.8%) 250 (35.7%)∗ 84 (53.8%) - 24 (46.2%) 450 (64.3%) 72 (46.2%) Hormone receptor + 18 (34.6%) 488 (69.7%)∗ 54 (34.6%) - 34 (65.4%) 212 (30.3%) 102 (65.4%) Her2 + 40 (76.9%) 149 (21.3%)∗ 120 (76.9%) - 12 (23.1%) 551 (78.7%) 36 (23.1%) 5y Relapse-Free Survival 52.2% 86.7%∗ 81.4%∗ 5y Overall Survival 62.1% 91.8%∗ 85.9%∗ ∗compared with PD group, P<0.05 156 patients were recruited in the matched group. The 5-year relapsefree survival and overall survival were both lower for patients in PD group than those in the matched group (table1). [Conclusions] Patients with invasive breast cancer and Paget’s disease tended to have larger size, more lymph nodes involvement, lower hormone receptor expression, higher HER2 expression and worse survival than those without PD. The matched study confirmed the survival disadvantage of patients with Paget’s disease and underlying invasive breast cancer. Thus, oncologists should regard such patients as having high risk for relapse. Pathologists should exam the nipple-areola section carefully after mastectomy although the patient has no macroscopic nipple-areola change. |
Re: Paget's Information from SABCS abstract
Wow, looks like I'm in the lucky 50% of the Paget's group since I'm hitting the 5 year mark and still NED!
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