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Feb 27, 2013 10:39AM
momof5inva...I found this abstract: Int J Radiat Oncol Biol Phys.
2009 Dec 1;75(5):1304-8. doi: 10.1016/j.ijrobp.2008.12.070. Epub 2009 Apr 20.
Clinical-pathologic features and long-term outcomes of tubular carcinoma of the breast compared with invasive ductal carcinoma treated with breast conservation therapy.
, Yang Q
, Haffty BG
, Moran MS
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT 06520-8040, USA.
To evaluate our institutional experience of treating tubular carcinoma of the breast (TC) and invasive ductal carcinoma (IDC) with conservative surgery and radiation therapy, to compare clinical-pathologic features and long-term outcomes.
METHODS AND MATERIALS:
A review of our institution's tumor registry from 1975 to 2007, followed by a central pathology review of available slides, yielded 71 cases of Stage I/II TC and 2,238 cases of Stage I/II IDC treated with breast conservation therapy. Clinical-pathologic features and outcomes were analyzed by subtype to detect significant differences.
The median follow-up was 7 years. The TC cohort presented more frequently with pT1 disease (97% vs. 80%, p = 0.0007), pN0 disease (95% vs. 74%, p = 0.0004), hormone-receptor positivity (ER+, 89% vs. 62%, p = 0.0001; PR+, 81% vs. 52%, p = 0.0001), and HER-2 negativity (89% vs. 71%, p = 0.04). Clinical outcomes also favored the TC cohort, with lower rates of breast cancer-related death (1% vs. 10%; p = 0.0109) and distant metastasis (1% vs. 13%; p = 0.0028) and higher rates of 10-year overall (90% vs. 80%; p = 0.033), cause-specific (99% vs. 86%; p = 0.011), and disease-free (99% vs. 82%; p = 0.003) survival. There was a nonsignificant trend toward improved breast cancer relapse-free survival for the TC cohort (95% vs. 87%; p = 0.062) but no difference in nodal relapse-free survival or contralateral breast cancer relapse-free survival (all p values >0.05) between the cohorts.
Our institutional experience suggests that TC, when compared with IDC, is associated with more favorable clinical-pathologic features and comparable, if not superior, outcomes after breast conservation therapy, suggesting the appropriateness of a conservative approach to this rare subtype.
Notice there were 71 cases of Tubular bc. Of them, 89% were ER Positive. So, while Tubular is rare, Tubular that is ER NEGATIVE is rarer...occuring in 11% of cases. But notice, according to this study...at 10 years...disease free survival was 99% for all cases. So, even those who were ER NEGATIVE, they had EXCELLENT outcomes.
I think it's a great idea to have the Oncotype DX test. However, for Tubular and Mucinous breast cancers, the test is not as strongly validated as it is for "traditional" types of breast cancers.
Good luck. Let us know your score and decision.
Doctor told me regarding my prognosis that I WASN'T on the Titanic! Hmmm...Really?....Okay! 02/2010 Pure Mucinous Breast Cancer, Oncotype DX 15, Stage 1, Grade 1, 1.8 cm, 0/2 nodes, ER+ 90% /PR+ 70% HER2- (+1)