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Influence of uncommon histology on breast conservation therapy for breast cancer‐biology dictates technique?
Author(s) -
Wasif Nabil,
McCullough Ann E.,
Gray Richard J.,
Pockaj Barbara A.
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.22132
Subject(s) - medicine , breast cancer , invasive lobular carcinoma , medullary cavity , mastectomy , lobular carcinoma , histology , ductal carcinoma , medullary carcinoma , breast conserving surgery , mucinous carcinoma , oncology , radiation therapy , radiology , cancer , adenocarcinoma , invasive ductal carcinoma , thyroid , thyroid carcinoma
Although trends and variations in the use of breast conservation therapy (BCT) for ductal carcinoma have been studied, little is known about uncommon breast cancer histologies. Methods The Surveillance, Epidemiology and End Results (SEER) database was used to identify 338,682 patients with T1 or T2 (≤5 cm) ductal, lobular, tubular, mucinous, medullary, or papillary carcinoma of the breast from 1998 to 2008. Multivariate logistic regression analysis was used to identify predictors of BCT. Results The majority of patients underwent BCT (60%). The rate of BCT remained relatively constant from 1998 to 2008 overall but varied from 50% for lobular to 79% for tubular. The highest rate of mastectomy was seen in lobular (49%). Nodal positivity following surgical staging was lowest for tubular (6%) and mucinous (8%). Adjuvant radiation was given to 72% overall and was lowest for papillary (58%). Predictors of BCT included tubular (OR 1.8, 95% CI 1.7–1.9) and medullary (OR 2.0, 95% CI 1.8–2.2) subtypes (vs. ductal). Conclusions Patients with uncommon breast cancer histologies show wide variation in the application of BCT depending on the primary tumor. This suggests that an individualized approach in the use of BCT depending on histology should be used. J. Surg. Oncol. 2012; 105:586–590. © 2011 Wiley Periodicals, Inc.