Tumour location within the breast: Does tumour site have prognostic ability?

Seth Rummel, Matthew Timothy Hueman, Nick Costantino, Craig D. Shriver, Rachel E. Ellsworth

Research output: Contribution to journalArticle

Abstract

Introduction: Tumour location within the breast varies with the highest frequency in the upper outer quadrant (UOQ) and lowest frequency in the lower inner quadrant (LIQ). Whether tumour location is prognostic is unclear. To determine whether tumour location is prognostic, associations between tumour site and clinicopathological characteristics were evaluated. Materials and Methods: All patients enrolled in the Clinical Breast Care Project whose tumour site - UOQ, upper inner quadrant (UIQ), central, LIQ, lower outer quadrant (LOQ) - was determined by a single, dedicated breast pathologist were included in this study. Patients with multicentric disease (n = 122) or tumours spanning multiple quadrants (n = 381) were excluded from further analysis. Clinicopathological characteristics were analysed using chi-square tests for univariate analysis with multivariate analysis performed using principal components analysis (PCA) and multiple logistic regression. Significance was defined as P <0.05. Results: Of the 980 patients with defined tumour location, 30 had bilateral disease. Tumour location in the UOQ (51.5%) was significantly higher than in the UIQ (15.6%), LOQ (14.2%), central (10.6%), or LIQ (8.1%). Tumours in the central quadrant were significantly more likely to have higher tumour stage (P = 0.003) and size (P <0.001), metastatic lymph nodes (P <0.001), and mortality (P = 0.011). After multivariate analysis, only tumour size and lymph node status remained significantly associated with survival. Conclusions: Evaluation of tumour location as a prognostic factor revealed that although tumours in the central region are associated with less favourable outcome, these associations are not independent of location but rather driven by larger tumour size. Tumours in the central region are more difficult to detect mammographically, resulting in larger tumour size at diagnosis and thus less favourable prognosis. Together, these data demonstrate that tumour location is not an independent prognostic factor.

Original languageEnglish (US)
Article number552
Journalecancermedicalscience
Volume9
DOIs
StatePublished - Jul 13 2015
Externally publishedYes

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Breast Neoplasms
Neoplasms
Breast
Multivariate Analysis
Lymph Nodes
Chi-Square Distribution
Principal Component Analysis
Logistic Models
Survival

Keywords

  • Breast quadrants
  • Prognosis
  • Tumour location

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Tumour location within the breast : Does tumour site have prognostic ability? / Rummel, Seth; Hueman, Matthew Timothy; Costantino, Nick; Shriver, Craig D.; Ellsworth, Rachel E.

In: ecancermedicalscience, Vol. 9, 552, 13.07.2015.

Research output: Contribution to journalArticle

Rummel, Seth ; Hueman, Matthew Timothy ; Costantino, Nick ; Shriver, Craig D. ; Ellsworth, Rachel E. / Tumour location within the breast : Does tumour site have prognostic ability?. In: ecancermedicalscience. 2015 ; Vol. 9.
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title = "Tumour location within the breast: Does tumour site have prognostic ability?",
abstract = "Introduction: Tumour location within the breast varies with the highest frequency in the upper outer quadrant (UOQ) and lowest frequency in the lower inner quadrant (LIQ). Whether tumour location is prognostic is unclear. To determine whether tumour location is prognostic, associations between tumour site and clinicopathological characteristics were evaluated. Materials and Methods: All patients enrolled in the Clinical Breast Care Project whose tumour site - UOQ, upper inner quadrant (UIQ), central, LIQ, lower outer quadrant (LOQ) - was determined by a single, dedicated breast pathologist were included in this study. Patients with multicentric disease (n = 122) or tumours spanning multiple quadrants (n = 381) were excluded from further analysis. Clinicopathological characteristics were analysed using chi-square tests for univariate analysis with multivariate analysis performed using principal components analysis (PCA) and multiple logistic regression. Significance was defined as P <0.05. Results: Of the 980 patients with defined tumour location, 30 had bilateral disease. Tumour location in the UOQ (51.5{\%}) was significantly higher than in the UIQ (15.6{\%}), LOQ (14.2{\%}), central (10.6{\%}), or LIQ (8.1{\%}). Tumours in the central quadrant were significantly more likely to have higher tumour stage (P = 0.003) and size (P <0.001), metastatic lymph nodes (P <0.001), and mortality (P = 0.011). After multivariate analysis, only tumour size and lymph node status remained significantly associated with survival. Conclusions: Evaluation of tumour location as a prognostic factor revealed that although tumours in the central region are associated with less favourable outcome, these associations are not independent of location but rather driven by larger tumour size. Tumours in the central region are more difficult to detect mammographically, resulting in larger tumour size at diagnosis and thus less favourable prognosis. Together, these data demonstrate that tumour location is not an independent prognostic factor.",
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N2 - Introduction: Tumour location within the breast varies with the highest frequency in the upper outer quadrant (UOQ) and lowest frequency in the lower inner quadrant (LIQ). Whether tumour location is prognostic is unclear. To determine whether tumour location is prognostic, associations between tumour site and clinicopathological characteristics were evaluated. Materials and Methods: All patients enrolled in the Clinical Breast Care Project whose tumour site - UOQ, upper inner quadrant (UIQ), central, LIQ, lower outer quadrant (LOQ) - was determined by a single, dedicated breast pathologist were included in this study. Patients with multicentric disease (n = 122) or tumours spanning multiple quadrants (n = 381) were excluded from further analysis. Clinicopathological characteristics were analysed using chi-square tests for univariate analysis with multivariate analysis performed using principal components analysis (PCA) and multiple logistic regression. Significance was defined as P <0.05. Results: Of the 980 patients with defined tumour location, 30 had bilateral disease. Tumour location in the UOQ (51.5%) was significantly higher than in the UIQ (15.6%), LOQ (14.2%), central (10.6%), or LIQ (8.1%). Tumours in the central quadrant were significantly more likely to have higher tumour stage (P = 0.003) and size (P <0.001), metastatic lymph nodes (P <0.001), and mortality (P = 0.011). After multivariate analysis, only tumour size and lymph node status remained significantly associated with survival. Conclusions: Evaluation of tumour location as a prognostic factor revealed that although tumours in the central region are associated with less favourable outcome, these associations are not independent of location but rather driven by larger tumour size. Tumours in the central region are more difficult to detect mammographically, resulting in larger tumour size at diagnosis and thus less favourable prognosis. Together, these data demonstrate that tumour location is not an independent prognostic factor.

AB - Introduction: Tumour location within the breast varies with the highest frequency in the upper outer quadrant (UOQ) and lowest frequency in the lower inner quadrant (LIQ). Whether tumour location is prognostic is unclear. To determine whether tumour location is prognostic, associations between tumour site and clinicopathological characteristics were evaluated. Materials and Methods: All patients enrolled in the Clinical Breast Care Project whose tumour site - UOQ, upper inner quadrant (UIQ), central, LIQ, lower outer quadrant (LOQ) - was determined by a single, dedicated breast pathologist were included in this study. Patients with multicentric disease (n = 122) or tumours spanning multiple quadrants (n = 381) were excluded from further analysis. Clinicopathological characteristics were analysed using chi-square tests for univariate analysis with multivariate analysis performed using principal components analysis (PCA) and multiple logistic regression. Significance was defined as P <0.05. Results: Of the 980 patients with defined tumour location, 30 had bilateral disease. Tumour location in the UOQ (51.5%) was significantly higher than in the UIQ (15.6%), LOQ (14.2%), central (10.6%), or LIQ (8.1%). Tumours in the central quadrant were significantly more likely to have higher tumour stage (P = 0.003) and size (P <0.001), metastatic lymph nodes (P <0.001), and mortality (P = 0.011). After multivariate analysis, only tumour size and lymph node status remained significantly associated with survival. Conclusions: Evaluation of tumour location as a prognostic factor revealed that although tumours in the central region are associated with less favourable outcome, these associations are not independent of location but rather driven by larger tumour size. Tumours in the central region are more difficult to detect mammographically, resulting in larger tumour size at diagnosis and thus less favourable prognosis. Together, these data demonstrate that tumour location is not an independent prognostic factor.

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KW - Prognosis

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