55P Prognostic Role of Palpability in Screen Detected Breast Cancer (BC)

Abstract

ABSTRACT Introduction Screen detected BC has excellent outcome due to lead time and length bias, but approximately 30% of the mortality reduction through screening remains unexplained. On the other hand, not all patients with screen detected BC have excellent outcome as some will eventually relapse. Therefore, new prognostic variables in screen detected BC are needed and we here study palpability as a candidate variable. Previously, Gill et al (J Med Screen, 2006; 13:98-101), did not find an independent prognostic value for palpability within screen detected BC. Patients and methods Primary operable invasive BC treated at UZ-Leuven (01/2000 – 12/2009). Preoperative systemic therapy (n = 407), metastases at diagnosis (n = 228), male patients (n = 28) or external surgery (n = 530) were exclusion criteria. Details on treatment and pathology are described in detail elsewhere (Brouckaert et al, Breast Cancer Res Treat., 2009 May; 115 (2):349-58). We included 1610 patients with screen detected BC. Missing data for palpability were 2. Palpability was assessed preoperatively by the treating physician. Multivariable Cox proportional hazard models were used adjusting for age, size, grade, nodal status, ER, PR and HER2 receptor status and adjuvant therapy. The proportional hazard assumption for the Cox model was evaluated by including time-dependent covariates in the models, which were included when significant. Results Median follow-up is 6.1 years. Most screen detected BC are grade 1 or 2 (72%), ER (90%) positive, PR (79%) positive and 52% are palpable. Palpability (Hazard ratio (HR) 2,73 95% CI 1,26-5,92 (p = 0,0107)) is an independent prognostic variable for distant metastasis free survival together with tumor size (HR 1,01 95% CI 1,00-1,03 (p = 0,0411)) and total number of positive lymph nodes (HR 1,11 95% CI 1,06-1,16 (p Conclusion Palpability is an independent prognostic variable in screen detected BC. Disclosure All authors have declared no conflicts of interest.