(S031) Prognostic Factors, Treatment, and Outcomes in Early-Stage, Invasive Papillary Breast Cancer

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Article
OncologyOncology Vol 30 No 4_Suppl_1
Volume 30
Issue 4_Suppl_1

Patients with early-stage papillary BCA are less likely to receive lumpectomy + XRT compared with IDC, although lumpectomy + XRT was associated with superior OS.

Mohamad H. Fakhreddine, MD, Vatsal Patel, MD, MBA, Awad Ahmed, MD, Arnold Paulino, MD, Mary Schwartz, MD, Angel Rodriguez, MD, Bin Teh, MD; UT Health Science Center at San Antonio; University of Miami; UT MD Anderson Cancer Center; Houston Methodist Hospital

BACKGROUND: Papillary breast cancer (BCA) histology, representing 0.5% of invasive BCA, is considered favorable; clinicians may treat early stages less aggressively. This study reports prognostic factors, outcomes, and treatment differences with invasive ductal carcinoma (IDC).

PATIENTS AND METHODS: Papillary cases, limited to stages T1–2 N0, were identified in the latest Surveillance, Epidemiology, and End Results (SEER) Registry 18. Univariate and multivariate analyses (UVA, MVA) were performed using variables of treatment, stage, race, estrogen receptor (ER)/progesterone receptor (PR) status, grade (G1–3), and age. Treatment included lumpectomy, lumpectomy with radiation (XRT), and mastectomy.

Treatment differences between papillary disease and IDC were analyzed during the last 5 years available in SEER (2007–2011).

RESULTS: Among 10,485 papillary cases, the median follow-up was 56 months, the median age was 53.0 years, and the 5-year and 10-year overall survival (OS) rates were 93.1% and 76.8%, respectively. Mastectomy represented 69.9% of cases vs 20.8% with lumpectomy and 9.3% for lumpectomy + XRT. Lumpectomy + XRT patients were oldest (mean age: 58.5 yr); mastectomy patients were youngest (mean age: 52.7 yr). Patients treated with lumpectomy alone had a higher proportion of T1 (89.9%; P < .0001) and G1 disease (58.1%; P < .0001).

On UVA, patients treated with lumpectomy + XRT had superior OS, with a mean of 16.8 years (14.9 yr for mastectomy; 14.2 yr for lumpectomy alone; P = .0003). Improved OS correlated with lower tumor grade (P < .0001) and lower T stage (P < .0001). Blacks had the lowest mean OS (12.7 yr; P < .0001). ER/PR status was not significant. MVA with Cox proportional hazards demonstrated treatment, age, tumor stage, race, and tumor grade to be significant. Lumpectomy + XRT had the lowest hazard ratio ([HR], 0.66; P = .0001). Lumpectomy alone and mastectomy had equivalent HRs. Worse OS was associated with higher T stage (HR, 1.46; P < .0001), G3 disease (HR, 1.46; P = .0009), and black race (HR, 1.40; P = .0003). From 2007 to 2011, papillary patients were treated with more mastectomies (79.8% vs 31.0%) and less lumpectomy + XRT (3.83% vs 52.71%; P < .0001). 

CONCLUSIONS: Patients with early-stage papillary BCA are less likely to receive lumpectomy + XRT compared with IDC, although lumpectomy + XRT was associated with superior OS. 

Proceedings of the 98th Annual Meeting of the American Radium Society - americanradiumsociety.org

Articles in this issue

(S002) A 15-Year Review of Radiation Therapy for Keloids at Two Institutions
(S003) Single-Fraction Radiation Therapy for the Treatment of Multiple Myeloma Bony Metastases Provides Pain Control and Decreases Time to Chemotherapy
(S001) Prognostic Value of Pretreatment Serum Inflammatory Markers in Patients Receiving Radiation Therapy for Oropharyngeal Cancer
(S004) Trend in Second Malignancy Risk for Head and Neck Cancer With Increased Utilization of IMRT: Analysis of SEER Database
(S005) Comparison of Legal Needs of a Group of Patients With Cancer: Economic and Geographic Factors
(S006) Mission Improvement: Lessons From Initiating a Resident-Led Quality Improvement Project on Smoking Cessation at a County Hospital
(S007) Results of a Phase II Trial Using Cetuximab Plus Docetaxel With Low-Dose Fractionated Radiation for Recurrent Unresectable Locally Advanced Head and Neck Carcinoma
(S008) The Effect of Simulation and Treatment Delays for Patients With Oropharyngeal Cancer Receiving Definitive Radiation Therapy in the Era of Risk Stratification Using Smoking and Human Papilloma Virus Status
(S009) Intensity-Modulated Radiation Therapy With Stereotactic Body Radiation Therapy Boost for Unfavorable Prostate Cancer: A Report on Three-Year Toxicity
(S011) Comparative Study Between Ileal Conduit and Indiana Pouch After Cystectomy for Patients With Carcinoma of Urinary Bladder
(S010) Computed Tomography–Assessed Measures of Bone Mineral Density and Muscle Mass as Predictors of Survival in Men With Prostate Cancer
(S012) Quantitative Imaging to Evaluate the Malignant Potential of Pancreatic Cysts
(S013) Spine Stereotactic Radiosurgery With Concurrent Tyrosine Kinase Inhibitors for Metastatic Renal Cell Carcinoma
(S014) The Impact of Radiation Therapy on Survival in Surgically Resected, High-Risk Patients With Ampullary Adenocarcinoma: A Population-Based Analysis
(S016) The Impact of Stereotactic Body Radiation Therapy on Overall Survival in Patients With Locally Advanced Pancreatic Cancer
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