Are Two-Centimeter Breast Cancers Large or Small?

S.A Narod,A Jakubowska,C Cybulski,J Lubinski,T Huzarski,J Gronwald,J Iqbal,P Sun,T Byrski

doi:10.3747/co.20.1364

Abstract

Node-negative breast cancers from 2 cm to 5 cm in size are classified as stage ii, and smaller cancers, as stage i. We sought to determine if the prognosis of women with a breast cancer exactly 2 cm in size more closely resembles that of women with a stage i or a stage ii breast cancer. Using a cohort of 4265 young women with breast cancer, we compared the 10-year breast cancer mortality rates for women who had a tumour 0.1-1.9 cm, exactly 2.0 cm, and 2.1-2.9 cm. In the first 3 years after diagnosis, the survival pattern of women with a 2.0-cm breast cancer was nearly identical to that of women with a larger cancer (2.1-3.0 cm). From year 3 to year 10, the relative survival of women with a 2.0-cm breast cancer was improved and nearly identical to that of women with a smaller cancer. The 10-year survival rate was 89.3% for women with tumours less than 20 mm, 86.1% for women with tumours equal to 20 mm, and 81.2% for women with 21-mm to 29-mm tumours. For young women with small breast cancers, the relative mortality from breast cancer is dynamic with increasing tumour size and varies with time from diagnosis.

Highlights

Cancers of exactly 2 cm in size occupy a special niche in breast oncology
For young women with small breast cancers, the relative mortality from breast cancer is dynamic with increasing tumour size and varies with time from diagnosis
In patients who present with localized breast cancer, increasing tumour size is inversely correlated with breast cancer–specific survival[1,2,3,4,5]

Summary

Introduction

Cancers of exactly 2 cm in size occupy a special niche in breast oncology. That size is the one at which breast cancer is most commonly diagnosed (the “modal size”) and 2.0 cm marks the boundary between stage i and ii for node-negative breast cancers and between stage ii and iii for node-positive breast cancers. The size of the primary tumour and the nodal status are the two most useful parameters for predicting prognosis in breast cancer patients and for planning clinical management. In patients who present with localized breast cancer, increasing tumour size is inversely correlated with breast cancer–specific survival[1,2,3,4,5]. We examined size distribution and tumour characteristics in 4265 unselected breast cancer patients diagnosed at age 50 or younger. Node-negative breast cancers from 2 cm to 5 cm in size are classified as stage ii, and smaller cancers, as stage i. We sought to determine if the prognosis of women with a breast cancer exactly 2 cm in size more closely resembles that of women with a stage i or a stage ii breast cancer

Methods

Results

Discussion

Conclusion