Foulkes William D, Grainge Matthew J, Rakha Emad A, Green Andrew R, Ellis Ian O
Departments of Oncology and Human Genetics, McGill University, Montreal, QC, Canada.
Breast Cancer Res Treat. 2009 Sep;117(1):199-204. doi: 10.1007/s10549-008-0102-6. Epub 2008 Jul 4.
Larger breast tumors tend to be associated with a greater number of axillary lymph nodes involved with metastatic tumor than are smaller tumors. This rule may not fully apply in BRCA1-related breast cancers. We hypothesized that the rule also might not apply in basal-like breast cancers (BLBC), and further, that disruption of this relationship would impact on prognosis. In 1,324 non-BLBC (87.1% of 1520 tumors), after adjustment for grade, a strongly positive correlation between increasing tumor size and increasing number of lymph nodes involved by tumor was observed (P for trend <.001). The correlation was much weaker in 196 BLBC (12.9%) (P for trend = 0.58). Similarly, a worsening breast cancer-specific survival with increasing tumor size was observed in non-BLBC (P for trend <.001) but not in BLBC (P for trend = 0.43). The "size-nodes" relationship in BLBC is distinct and is similar to that seen in BRCA1-related breast cancer, further suggesting biological similarities between these sub-types of breast cancer. Moreover, tumor size is not a strong indicator of prognosis in BLBC.
与较小的乳腺肿瘤相比，较大的乳腺肿瘤往往与更多发生转移瘤累及的腋窝淋巴结相关。这一规律可能并不完全适用于与BRCA1相关的乳腺癌。我们推测这一规律可能也不适用于基底样乳腺癌（BLBC），并且进一步认为这种关系的破坏会影响预后。在1324例非基底样乳腺癌（占1520例肿瘤的87.1%）中，在调整分级后，观察到肿瘤大小增加与肿瘤累及淋巴结数量增加之间存在强正相关（趋势P值<.001）。在196例基底样乳腺癌（占12.9%）中，这种相关性要弱得多（趋势P值 = 0.58）。同样，在非基底样乳腺癌中观察到随着肿瘤大小增加，乳腺癌特异性生存率恶化（趋势P值<.001），但在基底样乳腺癌中未观察到（趋势P值 = 0.43）。基底样乳腺癌中的“大小-淋巴结”关系是独特的，与BRCA1相关乳腺癌中所见的关系相似，这进一步表明这些乳腺癌亚型之间存在生物学相似性。此外，肿瘤大小在基底样乳腺癌中并不是预后的有力指标。
