Biological and Prognostic Role of Tumor Size (T1a, T1b, T1c) in Stage I Breast Cancer (Experience of International Cooperation)

The aim of the investigation was to study shared distribution of tumors T_1a, T_1b and T_1c in two independent female populations: in the country with National breast cancer screening program (the Netherlands) and in the country with voluntary mammographic screening program (Russia), and assess biological and prognostic value of tumor size for the risk of further disease progression and cancer-related mortality.

Materials and Methods. We studied stage I breast cancer (T₁N₀M₀) heterogeneity in Russian and Dutch female population. The study involved Russian women who had undergone radical treatment in N.N. Blokhin Russian Cancer Research Center of Russian Academy of Medical Science and Clinic of Russian Medical Academy for Postgraduate Education (n=1341), Dutch women who had received treatment in LUMC (n=553) and the patients included in National Cancer Register of the Netherlands (n=22196).

Results. Percentage of tumors <10 mm (T_1a and T_1b) in Dutch women is significantly higher (to 34%) compared with that in Russian women (17.1%) that can be explained by the differences in breast cancer screening in these countries. Stage I breast cancer is a heterogeneous group with a favorable course, if microcarcinomas are <5 mm, and more aggressive — in tumors T_1b and T_1c. Only microcarcinomas T_1a have a favorable biological “portrait” (high percentage of luminal А-subtype tumors with low anaplasia degree) that has an impact on long-term treatment results (minimum recurrence rate and mortality rate and best long-term survival rate). Biological characteristics of tumors T_1b and T_1c are more aggressive and have higher percentage of ductal breast cancer with luminal В-subtype and triple negative cancer immunophenotype that significantly worsens the disease prognosis.

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Kolyadina I.V., Poddubnaya I.V., van de Velde Cornelis J.H., Kuppen Peter J.K., Bastiaannet E., Komov D.V., Karseladze A.I., Ermilova V.D., Vishnevskaya Y.V., Frank G.A. Biological and Prognostic Role of Tumor Size (T1a, T1b, T1c) in Stage I Breast Cancer (Experience of International Cooperation). Sovremennye tehnologii v medicine 2014; 6(3): 28