Are ulcerated breast cancers biologically more aggressive compared to their non-ulcerated counterparts?

Abstract

21 Background: Ulcerated breast carcinomas belong to the group of locally advanced breast cancers. In this study, the authors analyzed the biological presentation of ulcerated breast cancers (ULBC), examined their histo-pathological characteristics, and addressed the question whether T4b carcinomas have more aggressive phenotypes compared to their non-ulcerated counterparts (NULBC). Methods: In this case-control study the histo-pathologies of 66 patients with ulcerated locally advanced breast cancer were evaluated and compared with 132 consecutive non-ulcerated age-matched breast malignancies at the Medical University of Vienna and Comenius University School of Medicine of Bratislava. Results: The mean age in the ULBC and NULBC group was 64,86 (SD +/- 15,54) and 64,70 (SD +/- 14,11), respectively. The average tumor size at diagnosis in the ULBC group was 54.12 mm, 55% larger than in the NULBC group (p=<0.001). Furthermore, we detected statistical significantly more poorly differentiated (G3) tumors in the ULBC collection (p=0.003) and more Her-2-neu positive (p=0.035) breast cancers. In contrast, more hormone receptor positive (ER +/- PR positive) breast cancers were detected in the NULBC group (p=0.04). In addition, a total of 37.3% (n=25) patients with ULBC were diagnosed with primary metastasis. Conclusions: To our knowledge this is the first direct comparison between ULBC and NULBC.We could demonstrate that ulcerated breast cancers are characterized by more aggressive phenotypes. The observed differences of more unfavorable prognostic factors might contribute to the generally known poor prognosis of ULBC.