Disruption of the expected positive correlation between breast tumor size and lymph node status in BRCA1-related breast carcinoma

William D. Foulkes, Kelly Metcalfe, Wedad Hanna, Henry T. Lynch, Parviz Ghadirian, Nadine Tung, Olofunmilayo Olopade, Barbara Weber, Jane McLennan, Ivo A. Olivotto, Ping Sun, Pierre O. Chappuis, Louis R. Bégin, Jean Sébastien Brunet, Steven A. Narod

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Abstract

BACKGROUND. A positive correlation between breast tumor size and the number of axillary lymph nodes containing tumor is well established. It has been reported that patients with BRCA1-related breast carcinoma are more likely than patients with nonhereditary breast carcinoma to have negative lymph node status. Therefore, the authors questioned whether the known positive correlation between tumor size and lymph node status also was present in women with BRCA1-related breast carcinomas. METHODS. The relation between the greatest dimension of the resected breast tumor (size) and the presence of positive axillary lymph nodes (expressed as a percentage of all lymph nodes examined) was evaluated in 1555 women with invasive breast carcinoma who were ascertained at 10 centers in North America between 1975 and 1997. There were 276 BRCA1 mutation carriers, 136 BRCA2 carriers, and 1143 women without a known mutation (208 BRCA1/BRCA2 noncarriers and 935 untested women). Patients were stratified according to tumor size, and odds ratios were estimated for the presence of positive lymph nodes with increasing tumor size. RESULTS. A highly significant positive correlation between tumor size and the frequency of positive axillary lymph nodes was seen for BRCA1/BRCA2 noncarriers, for BRCA2 carriers, and for untested women (overall P <0.0001 for each). In contrast, there was no clear correlation between tumor size and positive lymph node status in BRCA1 carriers (overall P = 0.20). CONCLUSIONS. The relation between tumor size and lymph node status in patients with breast carcinoma appears to be different in BRCA1 carriers compared with BRCA2 carriers and noncarriers. These findings have important implications for estimating the route of metastatic spread and for evaluating the effectiveness of early diagnosis in patients with BRCA1-related breast carcinoma.

Original languageEnglish
Pages (from-to)1569-1577
Number of pages9
JournalCancer
Volume98
Issue number8
DOIs
StatePublished - Oct 15 2003

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Lymph Nodes
Breast Neoplasms
Neoplasms
Mutation
North America
Early Diagnosis
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Cancer Research
  • Oncology

Cite this

Disruption of the expected positive correlation between breast tumor size and lymph node status in BRCA1-related breast carcinoma. / Foulkes, William D.; Metcalfe, Kelly; Hanna, Wedad; Lynch, Henry T.; Ghadirian, Parviz; Tung, Nadine; Olopade, Olofunmilayo; Weber, Barbara; McLennan, Jane; Olivotto, Ivo A.; Sun, Ping; Chappuis, Pierre O.; Bégin, Louis R.; Brunet, Jean Sébastien; Narod, Steven A.

In: Cancer, Vol. 98, No. 8, 15.10.2003, p. 1569-1577.

Research output: Contribution to journalArticle

Foulkes, WD, Metcalfe, K, Hanna, W, Lynch, HT, Ghadirian, P, Tung, N, Olopade, O, Weber, B, McLennan, J, Olivotto, IA, Sun, P, Chappuis, PO, Bégin, LR, Brunet, JS & Narod, SA 2003, 'Disruption of the expected positive correlation between breast tumor size and lymph node status in BRCA1-related breast carcinoma', Cancer, vol. 98, no. 8, pp. 1569-1577. https://doi.org/10.1002/cncr.11688
Foulkes, William D. ; Metcalfe, Kelly ; Hanna, Wedad ; Lynch, Henry T. ; Ghadirian, Parviz ; Tung, Nadine ; Olopade, Olofunmilayo ; Weber, Barbara ; McLennan, Jane ; Olivotto, Ivo A. ; Sun, Ping ; Chappuis, Pierre O. ; Bégin, Louis R. ; Brunet, Jean Sébastien ; Narod, Steven A. / Disruption of the expected positive correlation between breast tumor size and lymph node status in BRCA1-related breast carcinoma. In: Cancer. 2003 ; Vol. 98, No. 8. pp. 1569-1577.
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title = "Disruption of the expected positive correlation between breast tumor size and lymph node status in BRCA1-related breast carcinoma",
abstract = "BACKGROUND. A positive correlation between breast tumor size and the number of axillary lymph nodes containing tumor is well established. It has been reported that patients with BRCA1-related breast carcinoma are more likely than patients with nonhereditary breast carcinoma to have negative lymph node status. Therefore, the authors questioned whether the known positive correlation between tumor size and lymph node status also was present in women with BRCA1-related breast carcinomas. METHODS. The relation between the greatest dimension of the resected breast tumor (size) and the presence of positive axillary lymph nodes (expressed as a percentage of all lymph nodes examined) was evaluated in 1555 women with invasive breast carcinoma who were ascertained at 10 centers in North America between 1975 and 1997. There were 276 BRCA1 mutation carriers, 136 BRCA2 carriers, and 1143 women without a known mutation (208 BRCA1/BRCA2 noncarriers and 935 untested women). Patients were stratified according to tumor size, and odds ratios were estimated for the presence of positive lymph nodes with increasing tumor size. RESULTS. A highly significant positive correlation between tumor size and the frequency of positive axillary lymph nodes was seen for BRCA1/BRCA2 noncarriers, for BRCA2 carriers, and for untested women (overall P <0.0001 for each). In contrast, there was no clear correlation between tumor size and positive lymph node status in BRCA1 carriers (overall P = 0.20). CONCLUSIONS. The relation between tumor size and lymph node status in patients with breast carcinoma appears to be different in BRCA1 carriers compared with BRCA2 carriers and noncarriers. These findings have important implications for estimating the route of metastatic spread and for evaluating the effectiveness of early diagnosis in patients with BRCA1-related breast carcinoma.",
author = "Foulkes, {William D.} and Kelly Metcalfe and Wedad Hanna and Lynch, {Henry T.} and Parviz Ghadirian and Nadine Tung and Olofunmilayo Olopade and Barbara Weber and Jane McLennan and Olivotto, {Ivo A.} and Ping Sun and Chappuis, {Pierre O.} and B{\'e}gin, {Louis R.} and Brunet, {Jean S{\'e}bastien} and Narod, {Steven A.}",
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T1 - Disruption of the expected positive correlation between breast tumor size and lymph node status in BRCA1-related breast carcinoma

AU - Foulkes, William D.

AU - Metcalfe, Kelly

AU - Hanna, Wedad

AU - Lynch, Henry T.

AU - Ghadirian, Parviz

AU - Tung, Nadine

AU - Olopade, Olofunmilayo

AU - Weber, Barbara

AU - McLennan, Jane

AU - Olivotto, Ivo A.

AU - Sun, Ping

AU - Chappuis, Pierre O.

AU - Bégin, Louis R.

AU - Brunet, Jean Sébastien

AU - Narod, Steven A.

PY - 2003/10/15

Y1 - 2003/10/15

N2 - BACKGROUND. A positive correlation between breast tumor size and the number of axillary lymph nodes containing tumor is well established. It has been reported that patients with BRCA1-related breast carcinoma are more likely than patients with nonhereditary breast carcinoma to have negative lymph node status. Therefore, the authors questioned whether the known positive correlation between tumor size and lymph node status also was present in women with BRCA1-related breast carcinomas. METHODS. The relation between the greatest dimension of the resected breast tumor (size) and the presence of positive axillary lymph nodes (expressed as a percentage of all lymph nodes examined) was evaluated in 1555 women with invasive breast carcinoma who were ascertained at 10 centers in North America between 1975 and 1997. There were 276 BRCA1 mutation carriers, 136 BRCA2 carriers, and 1143 women without a known mutation (208 BRCA1/BRCA2 noncarriers and 935 untested women). Patients were stratified according to tumor size, and odds ratios were estimated for the presence of positive lymph nodes with increasing tumor size. RESULTS. A highly significant positive correlation between tumor size and the frequency of positive axillary lymph nodes was seen for BRCA1/BRCA2 noncarriers, for BRCA2 carriers, and for untested women (overall P <0.0001 for each). In contrast, there was no clear correlation between tumor size and positive lymph node status in BRCA1 carriers (overall P = 0.20). CONCLUSIONS. The relation between tumor size and lymph node status in patients with breast carcinoma appears to be different in BRCA1 carriers compared with BRCA2 carriers and noncarriers. These findings have important implications for estimating the route of metastatic spread and for evaluating the effectiveness of early diagnosis in patients with BRCA1-related breast carcinoma.

AB - BACKGROUND. A positive correlation between breast tumor size and the number of axillary lymph nodes containing tumor is well established. It has been reported that patients with BRCA1-related breast carcinoma are more likely than patients with nonhereditary breast carcinoma to have negative lymph node status. Therefore, the authors questioned whether the known positive correlation between tumor size and lymph node status also was present in women with BRCA1-related breast carcinomas. METHODS. The relation between the greatest dimension of the resected breast tumor (size) and the presence of positive axillary lymph nodes (expressed as a percentage of all lymph nodes examined) was evaluated in 1555 women with invasive breast carcinoma who were ascertained at 10 centers in North America between 1975 and 1997. There were 276 BRCA1 mutation carriers, 136 BRCA2 carriers, and 1143 women without a known mutation (208 BRCA1/BRCA2 noncarriers and 935 untested women). Patients were stratified according to tumor size, and odds ratios were estimated for the presence of positive lymph nodes with increasing tumor size. RESULTS. A highly significant positive correlation between tumor size and the frequency of positive axillary lymph nodes was seen for BRCA1/BRCA2 noncarriers, for BRCA2 carriers, and for untested women (overall P <0.0001 for each). In contrast, there was no clear correlation between tumor size and positive lymph node status in BRCA1 carriers (overall P = 0.20). CONCLUSIONS. The relation between tumor size and lymph node status in patients with breast carcinoma appears to be different in BRCA1 carriers compared with BRCA2 carriers and noncarriers. These findings have important implications for estimating the route of metastatic spread and for evaluating the effectiveness of early diagnosis in patients with BRCA1-related breast carcinoma.

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U2 - 10.1002/cncr.11688

DO - 10.1002/cncr.11688

M3 - Article

VL - 98

SP - 1569

EP - 1577

JO - Cancer

JF - Cancer

SN - 0008-543X

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