Conservatively treated breast cancer: Outcome by histologic subtype

Bruce Haffty, Peter L. Perrotta, Barbara Ward, Meena Moran, Malcolm Beinfield, Charles McKhann, Diana Fischer, Darryl Carter

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Between 1970 and 1990, 1,008 patients with early-stage breast cancer were treated by conservative surgery without axillary dissection followed by radiation therapy to the intact breast in the Department of Therapeutic Radiology at Yale-New Haven Hospital. The patient population, broken down by histologic subtype, was as follows: 761 patients presented with infiltrating ductal carcinoma, 70 patients with pure intraductal, 38 intraductal with focal invasion, 54 infiltrating lobular, 21 tubular, 17 medullary, 16 mucinous, and 29 with other various histologic subtypes. Patients were followed on a regular basis by the referring physicians and radiation oncologists. Diagnostic studies for distant metastases were performed as clinically indicated. Annual mammography was a routine component of the follow-up program. As of 3/96, with a median follow-up of 10.5 years, 83 patients developed an ipsilateral breast tumor recurrence, and 109 patients developed distant metastases resulting in an overall 10-year breast recurrence-free rate of 84%, and a 10-year distant metastasis-free rate of 78%. There were significant differences in clinical stage, pathological nodal involvement, and administration of systemic therapy between various histologic subtypes. As expected, those patients with histologies of low metastatic potential (such as intraductal, tubular, and mucinous) had significantly superior distant recurrence-free survival rates. With respect to breast relapse rates, there were no statistically significant differences in the 5- and 10-year breast recurrence-free rates between any of the histologic subtypes. Patients with intraductal carcinoma with or without focal invasion had similar breast relapse rates as those with other histologic subtypes. Patients with lobular carcinoma in situ as a histologic component also had a similar overall breast relapse-free recurrence rate. In conclusion, long-term follow-up of conservatively treated breast cancer patients demonstrates no significant differences in ipsilateral breast tumor recurrence rates between various histologic subtypes. There are no histologies which had a statistically significantly higher breast-relapse rate than infiltrating ductal carcinomas and therefore no primary histologic subtype represents a relative contraindication to breast conservation therapy.

Original languageEnglish (US)
Pages (from-to)7-14
Number of pages8
JournalBreast Journal
Volume3
Issue number1
DOIs
StatePublished - Apr 22 1997
Externally publishedYes

Fingerprint

Breast Neoplasms
Recurrence
Breast
Ductal Carcinoma
Neoplasm Metastasis
Histology
Radiation Oncology
Carcinoma, Intraductal, Noninfiltrating
Segmental Mastectomy
Mammography
Dissection
Radiotherapy
Survival Rate
Physicians
Population

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Surgery
  • Oncology

Cite this

Haffty, B., Perrotta, P. L., Ward, B., Moran, M., Beinfield, M., McKhann, C., ... Carter, D. (1997). Conservatively treated breast cancer: Outcome by histologic subtype. Breast Journal, 3(1), 7-14. https://doi.org/10.1111/j.1524-4741.1997.tb00134.x
Haffty, Bruce ; Perrotta, Peter L. ; Ward, Barbara ; Moran, Meena ; Beinfield, Malcolm ; McKhann, Charles ; Fischer, Diana ; Carter, Darryl. / Conservatively treated breast cancer : Outcome by histologic subtype. In: Breast Journal. 1997 ; Vol. 3, No. 1. pp. 7-14.
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abstract = "Between 1970 and 1990, 1,008 patients with early-stage breast cancer were treated by conservative surgery without axillary dissection followed by radiation therapy to the intact breast in the Department of Therapeutic Radiology at Yale-New Haven Hospital. The patient population, broken down by histologic subtype, was as follows: 761 patients presented with infiltrating ductal carcinoma, 70 patients with pure intraductal, 38 intraductal with focal invasion, 54 infiltrating lobular, 21 tubular, 17 medullary, 16 mucinous, and 29 with other various histologic subtypes. Patients were followed on a regular basis by the referring physicians and radiation oncologists. Diagnostic studies for distant metastases were performed as clinically indicated. Annual mammography was a routine component of the follow-up program. As of 3/96, with a median follow-up of 10.5 years, 83 patients developed an ipsilateral breast tumor recurrence, and 109 patients developed distant metastases resulting in an overall 10-year breast recurrence-free rate of 84{\%}, and a 10-year distant metastasis-free rate of 78{\%}. There were significant differences in clinical stage, pathological nodal involvement, and administration of systemic therapy between various histologic subtypes. As expected, those patients with histologies of low metastatic potential (such as intraductal, tubular, and mucinous) had significantly superior distant recurrence-free survival rates. With respect to breast relapse rates, there were no statistically significant differences in the 5- and 10-year breast recurrence-free rates between any of the histologic subtypes. Patients with intraductal carcinoma with or without focal invasion had similar breast relapse rates as those with other histologic subtypes. Patients with lobular carcinoma in situ as a histologic component also had a similar overall breast relapse-free recurrence rate. In conclusion, long-term follow-up of conservatively treated breast cancer patients demonstrates no significant differences in ipsilateral breast tumor recurrence rates between various histologic subtypes. There are no histologies which had a statistically significantly higher breast-relapse rate than infiltrating ductal carcinomas and therefore no primary histologic subtype represents a relative contraindication to breast conservation therapy.",
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Haffty, B, Perrotta, PL, Ward, B, Moran, M, Beinfield, M, McKhann, C, Fischer, D & Carter, D 1997, 'Conservatively treated breast cancer: Outcome by histologic subtype', Breast Journal, vol. 3, no. 1, pp. 7-14. https://doi.org/10.1111/j.1524-4741.1997.tb00134.x

Conservatively treated breast cancer : Outcome by histologic subtype. / Haffty, Bruce; Perrotta, Peter L.; Ward, Barbara; Moran, Meena; Beinfield, Malcolm; McKhann, Charles; Fischer, Diana; Carter, Darryl.

In: Breast Journal, Vol. 3, No. 1, 22.04.1997, p. 7-14.

Research output: Contribution to journalArticle

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T2 - Outcome by histologic subtype

AU - Haffty, Bruce

AU - Perrotta, Peter L.

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AU - McKhann, Charles

AU - Fischer, Diana

AU - Carter, Darryl

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