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Breast cancer tumor sizes


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Breast Cancer Stages




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Given the relationship between tumour size and sizse, and given the conventional model of breast cancer spread, it seems logical that the principal goal of early detection should be to identify cancers when they are small and node-negative.

Undoubtedly, the best outcome would be the detection of all breast cancers when they are small and node-negative. However, there may also be an advantage to identifying node-positive Brfast when they are relatively small. Follow-up data from the Henrietta Tujor Database in Toronto was used to evaluate the relationship between tumour size and long-term survival in women with and without lymph-node metastases at diagnosis. The absolute mortality benefit of finding small compared with medium-sized or large-sized breast cancers was determined for the two groups of women. The implications of the results, with regard to the differential benefit of screening in node-negative and node-positive women, are discussed.

Clinical characteristics tumour size and lymph node status were retrieved from the medical records. For deceased patients, the date and cause of death are obtained by review of medical records and by a mortality linkage with the Cancer Care Ontario database. Tumour size was taken as the largest dimension of the tumour in centimeters determined by pathology examination.

Sizes tumor Breast cancer

Tumours larger than 5 cm in size were found sjzes patients, and those women canncer excluded. Node status was defined as sizse or negative. For women, a nodal dissection was not done, and tummor women were also excluded, leaving patients for the analysis. The mean follow-up was nearly 10 years. He found that, for any tumro change in tumour size, the difference in mortality was greater for node-positive than for node-negative cancers. That observation might be seen as surprising if the assumption is that mammography is saving lives tuumor detecting small tumours before they spread from the canceg to the axillary lymph nodes and beyond.

However, closer inspection of earlier data for example, Figure 3 in Carter et al. Thus, Narod helpfully places the data in a modern context, allowing earlier findings to be reinterpreted in the light of modern biology. The most persuasive view regarding breast cancer progression holds that the die is cast early 7. In support of that opinion, the primary basal-like breast cancer from a woman who went on to develop a brain metastasis contained most of the critical mutations seen in the ultimately fatal metastasis—that is, the mutations in the brain metastasis did not arise de novo 8. Similar features have been reported in a lobular breast cancer 9.

Because small core basal and her2-positive breast cancers are prone to metastasize early 6those observations suggest that the intrinsic biology of many er-negative tumours, especially those arising in younger women, will inevitably thwart efforts to reduce breast cancer mortality by detecting tumours at ever-decreasing sizes. On the face of the available data, such an effort would seem warranted. In their study, which included nearly 25, women diagnosed in the United States between and that is, before chemotherapy was in widespread useCarter et al. One can thus imagine two women, one screened and one not, who are both destined to develop a 4-cm breast cancer with 5 positive nodes over the same time course.

It is a matter for speculation whether that scenario would hold true for all subtypes of breast cancer Brrast for all ages. It is tempting to hypothesize that such an improvement in outcome will be limited to tumours that are er-positive, because the relationship between tumour size, number of positive lymph nodes, and ultimate survival is fairly constant, except for tnbcs and basal-like breast cancers in which the relationship xizes attenuated 4. They found that, among siaes with invasive breast cancer less than 5 cm in size, 79 lesions were detected by mammogram alone; the other were palpable or lymph node—positive or both.

Those findings do not offer much comfort to the advocates of mammography; the tumours that imaging can reliably detect are not often fatal, and the tumours that are often fatal cannot be reliably detected. They found that, among women with invasive breast cancer less than 5 cm in size, 79 lesions were detected by mammogram alone; the other were palpable or lymph node—positive or both. Those findings do not offer much comfort to the advocates of mammography; the tumours that imaging can reliably detect are not often fatal, and the tumours that are often fatal cannot be reliably detected.

Uncomplicated, nongenomic studies such as those published here in Current Oncology force us to question how much we truly understand about the apparently simple relationship between tumour size, axillary lymph node status, and survival. Furthermore, they demand a re-examination of some of the assumptions underlying attempts to diagnose breast cancers at ever diminishing sizes.

Tumor wire and sexism in have cancer—a reappraisal. They found that, among commons with invasive breast augmentation less than 5 cm in meeting, 79 lesions were told by mammogram alone; the other were wary or post wedding—positive or both.

Indeed, iszes studies may lead to a rethink of the overall rationale for mammography as a screening tool. As many researchers and clinicians turn their attention to personalizing medicine, it is worth remembering that the generalities remain frustratingly obscure. Relation of tumor size, lymph node status, and survival in 24, breast cancer cases. Cancer of the breast: Clin Cancer Res ; Tumor size is an unreliable predictor of prognosis in basal-like breast cancers and does not correlate closely with lymph node status. Breast Cancer Res Treat ; Intrinsic breast tumor subtypes, race, and long-term survival in the Carolina Breast Cancer Study.

Tumor size and survival in breast cancer—a reappraisal. Nat Rev Clin Oncol ;7: Genome remodelling in a basal-like breast cancer metastasis and xenograft. Mutational evolution in a lobular breast tumour profiled at single nucleotide resolution.


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