A novel method for prediction of long-term outcome of women with T1a, T1b, and 10-14 mm invasive breast cancers: A prospective study

László Tabár, Hsiu Hsi Chen, Stephen W. Duffy, M. F. Yen, C. F. Chiang, Peter B. Dean, Robert A. Smith

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Abstract

Background: Women with small mammographically detected breast cancers generally have good long-term outcomes, but a few with T1a (1-5 mm) and T1b (6-10 mm) tumours will eventually die from breast cancer. We investigated whether women at high risk of breast-cancer death could be identified with mammographic criteria and differentiated from women with small cancers of the breast and good outcomes. Methods: We prospectively applied mammographic classifications of tumour type to a consecutive series of 343 mammograms of invasive breast cancers of size 1-14 mm. Classifications were: stellate (spiculated) mass with no calcifications; circular or oval lesions with no calcifications; spiculated or circular lesions with non-casting-type calcifications; and casting-type calcifications: Findings: 20-year survival for women with 1-14 mm invasive tumours with casting-type calcifications was 55%. 14% of 138 women with 1-9 mm tumours had casting-type calcifications on mammography, which accounted for 73% of all breast-cancer deaths (p <0.001). T1a, T1b, and 10-14 mm tumours with casting-type calcifications behaved as if they were larger lesions, since the rate of death was similar to that for women with advanced high-grade tumours. Most women who died were node-negative. The long-term survival of women who had tumours of 1-9 mm with no casting-type calcifications was about 95%. Interpretation: Mammographic classification seemed to reliably predict good and bad long-term outcomes for survival in tumours of 14 mm or smaller, and especially for those smaller than 10 mm. The implications for therapy are substantial.

Original languageEnglish
Pages (from-to)429-433
Number of pages5
JournalThe Lancet
Volume355
Issue number9202
DOIs
Publication statusPublished - Feb 5 2000
Externally publishedYes

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Prospective Studies
Breast Neoplasms
Neoplasms
Survival
Mammography
Mortality

ASJC Scopus subject areas

  • Medicine(all)

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A novel method for prediction of long-term outcome of women with T1a, T1b, and 10-14 mm invasive breast cancers : A prospective study. / Tabár, László; Chen, Hsiu Hsi; Duffy, Stephen W.; Yen, M. F.; Chiang, C. F.; Dean, Peter B.; Smith, Robert A.

In: The Lancet, Vol. 355, No. 9202, 05.02.2000, p. 429-433.

Research output: Contribution to journalArticle

Tabár, László ; Chen, Hsiu Hsi ; Duffy, Stephen W. ; Yen, M. F. ; Chiang, C. F. ; Dean, Peter B. ; Smith, Robert A. / A novel method for prediction of long-term outcome of women with T1a, T1b, and 10-14 mm invasive breast cancers : A prospective study. In: The Lancet. 2000 ; Vol. 355, No. 9202. pp. 429-433.
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abstract = "Background: Women with small mammographically detected breast cancers generally have good long-term outcomes, but a few with T1a (1-5 mm) and T1b (6-10 mm) tumours will eventually die from breast cancer. We investigated whether women at high risk of breast-cancer death could be identified with mammographic criteria and differentiated from women with small cancers of the breast and good outcomes. Methods: We prospectively applied mammographic classifications of tumour type to a consecutive series of 343 mammograms of invasive breast cancers of size 1-14 mm. Classifications were: stellate (spiculated) mass with no calcifications; circular or oval lesions with no calcifications; spiculated or circular lesions with non-casting-type calcifications; and casting-type calcifications: Findings: 20-year survival for women with 1-14 mm invasive tumours with casting-type calcifications was 55{\%}. 14{\%} of 138 women with 1-9 mm tumours had casting-type calcifications on mammography, which accounted for 73{\%} of all breast-cancer deaths (p <0.001). T1a, T1b, and 10-14 mm tumours with casting-type calcifications behaved as if they were larger lesions, since the rate of death was similar to that for women with advanced high-grade tumours. Most women who died were node-negative. The long-term survival of women who had tumours of 1-9 mm with no casting-type calcifications was about 95{\%}. Interpretation: Mammographic classification seemed to reliably predict good and bad long-term outcomes for survival in tumours of 14 mm or smaller, and especially for those smaller than 10 mm. The implications for therapy are substantial.",
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AU - Duffy, Stephen W.

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AU - Chiang, C. F.

AU - Dean, Peter B.

AU - Smith, Robert A.

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