Titre du document / Document title

The effect of tumor size and lymph node status on Breast carcinoma lethality

Auteur(s) / Author(s)

MICHAELSON James S. ^{(1 2)} ; SILVERSTEIN Melvin ⁽³⁾ ; SGROI Dennis ^{(1 2)} ; CHEONGSIATMOY Justin A. ⁽⁴⁾ ; TAGHIAN Alphonse ⁽⁵⁾ ; POWELL Simon ⁽⁵⁾ ; HUGHES Kevin ⁽⁴⁾ ; COMEGNO Arthur ⁽⁴⁾ ; TANABE Kenneth K. ⁽⁴⁾ ; SMITH Barbara ⁽⁴⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, ETATS-UNIS
⁽²⁾ Department of Pathology, Harvard Medical School, Boston, Massachusetts, ETATS-UNIS
⁽³⁾ Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California, ETATS-UNIS
⁽⁴⁾ Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, ETATS-UNIS
⁽⁵⁾ Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts, ETATS-UNIS

Résumé / Abstract

BACKGROUND. It has long been known that both tumor size and the presence of malignant disease in the regional lymph nodes are indicators of outcome for patients with invasive breast carcinoma; however, the way in which these two characteristics could be integrated into an overall assessment of prognosis has not been obvious. METHODS. Kaplan-Meier survival estimates (15 years) according to tumor size and lymph node status were obtained for women with invasive breast carcinoma who were observed at the University of Southern California/Van Nuys Breast Center (Van Nuys, California) or at Massachusetts General Hospital (Boston, Massachusetts). RESULTS. To isolate the individual contributions to death made by tumor size and lymph node status, data were sorted according to both of these variables. For women with tumors of equivalent size, lethality increased with increasing number of positive lymph nodes, such that there was an extra 6% chance of death associated with each positive lymph node. For women with equivalent lymph node status, tumor size was associated with increased lethality, such that each millimeter of tumor diameter was associated with an additional 1% chance of death. The overall lethality was equal to the sum of the contribution from lymph node status and the contribution from tumor size, and this finding led to the creation of a new technique (the Size+ Nodes method) for predicting outcome. CONCLUSIONS. The Size+ Nodes method was shown to be capable of accurately estimating the risk of death due to invasive breast carcinoma from information on the size of the primary tumor and the number of positive lymph nodes. In addition, this method was used to stratify women into groups according to breast carcinoma lethality. In contrast, classification of women according to lymph node positivity, T status, or disease stage created groups with wide and overlapping levels of lethality.

Revue / Journal Title

Cancer   ISSN 0008-543X   CODEN CANCAR 

Source / Source

2003, vol. 98, n^o10, pp. 2133-2143 [11 page(s) (article)] (17 ref.)

Langue / Language

Anglais

Editeur / Publisher

Wiley-Liss, New York, NY, ETATS-UNIS  (1948) (Revue)

Mots-clés anglais / English Keywords

Malignant hemopathy ; Mammary gland diseases ; Malignant tumor ; Human ; Prognosis ; Mortality ; Malignant lymphadenopathy ; Lymph node ; Metastasis ; Size ; Mammary gland ; Carcinoma ;

Mots-clés français / French Keywords

Hémopathie maligne ; Glande mammaire pathologie ; Tumeur maligne ; Homme ; Pronostic ; Mortalité ; Adénopathie maligne ; Ganglion lymphatique ; Métastase ; Taille ; Glande mammaire ; Carcinome ;

Mots-clés espagnols / Spanish Keywords

Hemopatía maligna ; Glándula mamaria patología ; Tumor maligno ; Hombre ; Pronóstico ; Mortalidad ; Adenopatía maligna ; Ganglio linfático ; Metástasis ; Talla ; Glándula mamaria ; Carcinoma ;

Mots-clés d'auteur / Author Keywords

breast carcinoma ; risk of death ; tumor size ; lymph node status ;

Localisation / Location

INIST-CNRS, Cote INIST : 2701, 35400011871762.0080