Dahi PB, Dhiran KP, Axiotis CA, Weedon J, El-Tamer M, Sidhu G, Braverman AS. Correlation between the proportion of breast volume involved by locally advanced tumors and invasion of the skin and posterior structures. World J Clin Oncol 2012; 3(3): 43-47 [PMID: 22442757 DOI: 10.5306/wjco.v3.i3.43]
Corresponding Author of This Article
Albert S Braverman, MD, Division of Hematology/Oncology, Department of Medicine, Downstate Medical College of the State University of NY, Box 55, DMC SUNY, 450 Clarkson Ave, Brooklyn, NY 11203, United States. abraverman@downstate.edu
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World J Clin Oncol. Mar 10, 2012; 3(3): 43-47 Published online Mar 10, 2012. doi: 10.5306/wjco.v3.i3.43
Correlation between the proportion of breast volume involved by locally advanced tumors and invasion of the skin and posterior structures
Parastoo B Dahi, Komal P Dhiran, Constantine A Axiotis, Jeremy Weedon, Mahmoud El-Tamer, Gurinder Sidhu, Albert S Braverman
Parastoo B Dahi, Gurinder Sidhu, Albert S Braverman, Division of Hematology/Oncology, Department of Medicine, Downstate Medical College of the State university of NY, Brooklyn, NY 11203, United States
Komal P Dhiran, Constantine A Axiotis, Division of Surgical Pathology, Kings County Hospital Center, Department of Pathology, Downstate Medical College of the State University of NY, Brooklyn, NY 11203, United States
Jeremy Weedon, Scientific Computing Center, Downstate Medical College of the State university of NY, Brooklyn, NY 11203, United States
Mahmoud El-Tamer, Breast Surgery Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, United States
Author contributions: Dahi PB, El-Tamer M and Braverman AS designed the project and wrote the manuscript; Dahi PB, El-Tamer M, Sidhu G and Braverman AS conducted the research; Dhiran KP and Axiotis CA provided pathological expertise; Dahi PB, Dhiran KP, Axiotis CA, Weedon J, El-Tamer M, Sidhu G and Braverman AS approved the manuscript.
Correspondence to: Albert S Braverman, MD, Division of Hematology/Oncology, Department of Medicine, Downstate Medical College of the State University of NY, Box 55, DMC SUNY, 450 Clarkson Ave, Brooklyn, NY 11203, United States. abraverman@downstate.edu
Telephone: +1-718-2701500 Fax: +1-718-2701544
Received: October 9, 2011 Revised: December 25, 2011 Accepted: March 5, 2012 Published online: March 10, 2012
Abstract
AIM: To evaluate any differences between the percentages of involved breast volume, pathologic attributes, and tumor marker expression of T3 and T4a-c tumors in locally advanced breast cancers (BC).
METHODS: All patients with T3N > 0 and T4a-c BC without evidence of distant metastasis (M0), presenting to the Breast Clinic from 1980 to 2010, were examined to determine whether their BC’s involved ≥ 50% of their breast volumes, defined by gross replacement of at least one hemisphere. Core needle biopsy or post-mastectomy specimens from tumors involving a known percent of breast volume were evaluated for: (1) pathological grades and lympho-vascular invasion (LVI); (2) hormone receptor (ER/PR) expression > 0; and (3) epidermoid growth factor 2 (her2) over-expression (3+) by immune-histochemical staining or fluorescent in situ hybridization.
RESULTS: The data base included 98 patients with T3N> 0 M0 and 120 with T4a-c, any N disease, M0 disease. T3 tumor masses involved 50% or more of the breast in 23/98 (24%), and T4a-c tumors 65/120 (54%) (P < 0.001). Only 1% of T3 tumors and 23% of T4a-c tumors presented with total breast replacement. There were no significant differences between the pathological attributes and marker expression of the T3 and T4a-c tumors.
CONCLUSION: These data suggest that erosion of the overlying skin or underlying chest wall by some BC may be due to neglect and delay, rather than inherent biological aggressiveness.
