Preview

Malignant tumours

Advanced search

CLINICAL AND BIOLOGICAL CHARACTERISTICS OF T3N0M0 AND T4N0M0 BREAST CANCER

https://doi.org/10.18027/2224-5057-2021-11-4-23-28

Abstract

T3–4N0M0 breast cancer is rather rare among all breast cancers. The clinical features of these tumors and their biological nature are poorly studied in the scientific literature. In this study we showed that patients with T3N0M0 and T4N0M0 tumors revealed a number of common clinical features, comorbidities and biological characteristics of the tumor. At the same time carcinomas differed in their aggressiveness and the course of the disease. The history was shorter and the average tumor size was larger among patients from T3N0M0 group than in the T4N0M0 group, which indicates a higher tumor growth rate. Also, mean proliferation index ki-67 was higher in the T3N0M0 group than in the T4N0M0 group. The proportion of triple-negative and luminal B Her2‑negative biological subtypes was the largest in both the T3N0M0 and T4N0M0 groups. More than 50 % of women with T3–4N0M0 tumors had carcinomas with zero or low expression of hormonal receptors. Thus, such tumors were more aggressive and potentially highly sensitive to systemic chemotherapy in a significant proportion of patients with T3–4N0M0 breast cancer in our study.

About the Authors

T. I. Gneteeva
I. M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Tatiana I. Gneteeva, Postgraduate Student, Department of Oncology

Moscow



V. Y. Kirsanov
I. M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Vladislav Yu. Kirsanov, MD, PhD, DSc, Associate Professor, Department of Oncology

Moscow



I. V. Visotskaya
I. M. Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

Irina V. Visotskaya, MD, PhD, DSc, Professor, Department of Oncology

Moscow



R. A. Kerimov
N. N. Blokhin National Medical Research Center of Oncology
Russian Federation

Ruslan A. Kerimov, MD, PhD, DSc, Oncologist, N. N. Blokhin National Medical Research Center of Oncology

Moscow



References

1. Каприн А. Д., Старинский В. В., Шахзадова А. О. Злокачественные новообразования в России в 2019 году. 2020. c. 250

2. Elmore L. et al. Postmastectomy radiation therapy in T3 node-negative breast cancer // J. Surg. Res. Academic Press Inc., 2015. Vol. 199, № 1. P. 90–96.

3. Aksu G. et al. The role of postoperative radiotherapy in node negative breast cancer patients with pT3–T4 disease // Eur. J. Surg. Oncol. 2007. Vol. 33, № 3. P. 285–293.

4. Yu K. Da et al. Effect of large tumor size on cancer-specific mortality in node-negative breast cancer // Mayo Clin. Proc. Elsevier Ltd, 2012. Vol. 87, № 12. P. 1171–1180.

5. Mignano J. E. et al. Local recurrence after mastectomy in patients with T3pN0 breast carcinoma treated without postoperative radiation therapy // Am. J. Clin. Oncol. Cancer Clin. Trials. 2007. Vol. 30, № 5. P. 466–472.

6. Haque W. et al. Postmastectomy radiation therapy for triple negative, node-negative breast cancer // Radiother. Oncol. Elsevier B. V., 2019. Vol. 132. P. 48–54.

7. American Cancer Society. // Breast Cancer Facts & Figures 2017-2018. 2017.

8. Brierley J. D., Gospodarowicz M. K., Wittekind Ch., eds. International Union Against Cancer (UICC). TNM Classi‑ fication of Malignant Tumours, 8th ed. Chichester, West Sussex, UK; Wiley-Blackwell; 2016. P. 272. ISBN: 978-1-11926356-2

9. Yang Z.-J. et al. The prognostic value of node status in different breast cancer subtypes // Oncotarget. 2017. Vol. 8, № 3. P. 4563–4571.

10. Min S. K. et al. Relation between tumor size and lymph node metastasis according to subtypes of breast cancer // J. Breast Cancer. 2021. Vol. 24, № 1. P. 75–84.

11. Zheng Y. Z. et al. Effect of tumor size on breast cancer-specific survival stratified by joint hormone receptor status in a SEER population-based study // Oncotarget. 2015. Vol. 6, № 26. P. 22985–22995.

12. Wu S. et al. Prognostic validation and therapeutic decision-making of the AJCC eighth pathological prognostic staging for T3N0 breast cancer after mastectomy // Clin. Transl. Med. 2020. Vol. 10, № 1. P. 125–136.

13. Güth U. et al. T4 category revision enhances the accuracy and significance of stage III breast cancer // Cancer. 2006. Vol. 106, № 12. P. 2569–2575.

14. Güth U. et al. A new approach in breast cancer with non-inflammatory skin involvement // Acta Oncol. (Madr). 2006. Vol. 45, № 5. P. 576–583.

15. Silverman D. et al. Skin involvement and breast cancer: Are T4b lesions of all sizes created equal? // J. Am. Coll. Surg. Elsevier Inc., 2014. Vol. 219, № 3. P. 534–544.

16. Yu J. B. et al. Postmastectomy radiation therapy for lymph node-negative, locally advanced breast cancer after modified radical mastectomy: Analysis of the NCI Surveillance, Epidemiology, and End Results database // Cancer. 2008. Vol. 113, № 1. P. 38–47.

17. Cassidy R. J. et al. The role of postmastectomy radiotherapy in women with pathologic T3N0M0 breast cancer // Cancer. 2017. Vol. 123, № 15. P. 2829–2839.

18. Высоцкая И. В., Летягин В. П., Максимов К. В. Прогностические факторы при раке молочной железы T3–Т4N0M0 стадий // Опухоли женской репродуктивной системы. 2010. c. 5–10.

19. Diaz D. A. et al. Locoregional outcomes in clinical stage IIB breast cancer after neoadjuvant therapy and mastectomy with or without radiation // Med. (United States). 2014. Vol. 93, № 29. P. e230.

20. Mazor A. M. et al. Breast conservation versus mastectomy in patients with T3 breast cancers (> 5 cm): an analysis of 37,268 patients from the National Cancer Database // Breast Cancer Res. Treat. Springer New York LLC, 2019. Vol. 173, № 2. P. 301–311.

21. Francis S. R. et al. Outcomes and utilization of postmastectomy radiotherapy for T3N0 breast cancers // Breast. Churchill Livingstone, 2017. Vol. 32. P. 156–161.

22. Nagar H. et al. Local-regional recurrence with and without radiation therapy after neoadjuvant chemotherapy and mastectomy for clinically staged T3N0 breast cancer // Int. J. Radiat. Oncol. Biol. Phys. 2011. Vol. 81, № 3. P. 782–787.

23. Parise C. A., Caggiano V. Risk of mortality of node-negative, ER/PR/HER2 breast cancer subtypes in T1, T2, and T3 tumors // Breast Cancer Res. Treat. Springer New York LLC, 2017. Vol. 165, № 3. P. 743–750.

24. Shen J. et al. Effective Local Control and Long-Term Survival in Patients with T4 Locally Advanced Breast Cancer Treated with Breast Conservation Therapy. 2004.

25. Harms K., Wittekind C. Prognosis of women with pT4b breast cancer: The significance of this category in the TNM system // Eur. J. Surg. Oncol. 2009. Vol. 35, № 1. P. 38–42.

26. Yıldırım E., Semerci E., Berberog U. The analysis of prognostic factors in stage III-B non-inflammatory breast cancer Introduction Patients and methods // European Journal of Surgical Oncology. 2000. Vol. 26. 34–38 p.

27. J Wieland A. W. et al. Determinants of Prognosis in Breast Cancer Patients with Tumor Involvement of the Skin (pT4b) // The Breast Journal. 2004. Vol. 10, № 2. 123–128 p.

28. Murphy B. L. et al. Contemporary operative management of T4 breast cancer // Surgery (United States). Mosby Inc., 2016. Vol. 160, № 4. P. 1059–1069.


Review

For citations:


Gneteeva T.I., Kirsanov V.Y., Visotskaya I.V., Kerimov R.A. CLINICAL AND BIOLOGICAL CHARACTERISTICS OF T3N0M0 AND T4N0M0 BREAST CANCER. Malignant tumours. 2021;11(4):23-28. (In Russ.) https://doi.org/10.18027/2224-5057-2021-11-4-23-28

Views: 2905


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2224-5057 (Print)
ISSN 2587-6813 (Online)