Correlation of grade & hormone-receptor status with stage in node-positive, non-metastatic breast cancer (#809)
Background: Features that influence treatment in non-metastatic breast cancer include tumour size, positive nodes, age, grade, hormone-receptor and Her-2 status. Larger cancers, positive nodes, higher grade and receptor negativity lead to worse outcome. TNM staging takes into account the first two variables. Correlation of grade and receptor status with stage is not well-documented. Studies suggest grade to correlate with stage and Her-2, however correlation of hormone-receptor status and stage is less clear. The aims of this study were to explore how grade and hormone-receptor status correlate with stage in node-positive non-metastatic breast cancer.
Methods: A retrospective review of
patients referred to Liverpool and Macarthur Cancer Centres with node-positive
non-metastatic breast cancer, diagnosed from January 2003 to November 2006. Variables examined included
tumour size, number of positive nodes, grade, hormone-receptor status, age and
race. We examined correlation of
grade and receptor status with stage II and III cancers using the Chi-squared
test and performed a multivariate analysis of variables for disease-free
Results: Total number of patients was 644, median follow-up 6.1 years, age 52.5 years, disease-free survival 148 months and overall survival 177 months. Grade 1, 2, 3 tumours comprised 20%, 40% and 40%. Receptor positive, stage II, stage III tumours were 79%, 66% and 34%. Grade correlated with stage (χ2 p-value 0.004), with 35% grade 3 and 24% grade 1 tumours in stage II; and 42% grade 3 and 13% grade 1 in stage III. Hormone-receptor status correlated with stage (χ2 p-value 0.014), with 16% receptor negative tumours in stage II and 24% in stage III. Multivariate analysis revealed larger size, more positive nodes, higher grade and negative hormone-receptor status to be associated with lower disease-free survival.
Conclusion: Disease-free survival factors and outcomes are consistent with published literature. Tumour grade and hormone-receptor status correlated with stage, with larger proportion of higher grade and receptor negative tumours in stage III than II. Future studies would validate these findings in a larger cohort and explore correlation with Her-2.