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Disruption of the expected positive correlation between breast tumor size and lymph node status in BRCA1-related breast carcinoma†
Article first published online: 8 SEP 2003
Published 2003 American Cancer Society
Volume 98, Issue 8, pages 1569–1577, 15 October 2003
How to Cite
Foulkes, W. D., Metcalfe, K., Hanna, W., Lynch, H. T., Ghadirian, P., Tung, N., Olopade, O., Weber, B., McLennan, J., Olivotto, I. A., Sun, P., Chappuis, P. O., Bégin, L. R., Brunet, J.-S. and Narod, S. A. (2003), Disruption of the expected positive correlation between breast tumor size and lymph node status in BRCA1-related breast carcinoma. Cancer, 98: 1569–1577. doi: 10.1002/cncr.11688
The opinions expressed herein do not necessarily reflect the views of the U.S. Government.
Fax: (514) 934-8273
- Issue published online: 3 OCT 2003
- Article first published online: 8 SEP 2003
- Manuscript Accepted: 8 JUL 2003
- Manuscript Revised: 4 JUL 2003
- Manuscript Received: 1 MAY 2003
- Canadian Genetic Diseases Network
- Susan G. Komen Foundation
- Fonds de la recherche en Santé du Québec
- National Institutes of Health
- breast carcinoma;
- tumor size;
- axillary lymph nodes;
- early diagnosis
A positive correlation between breast tumor size and the number of axillary lymph nodes containing tumor is well established. It has been reported that patients with BRCA1-related breast carcinoma are more likely than patients with nonhereditary breast carcinoma to have negative lymph node status. Therefore, the authors questioned whether the known positive correlation between tumor size and lymph node status also was present in women with BRCA1-related breast carcinomas.
The relation between the greatest dimension of the resected breast tumor (size) and the presence of positive axillary lymph nodes (expressed as a percentage of all lymph nodes examined) was evaluated in 1555 women with invasive breast carcinoma who were ascertained at 10 centers in North America between 1975 and 1997. There were 276 BRCA1 mutation carriers, 136 BRCA2 carriers, and 1143 women without a known mutation (208 BRCA1/BRCA2 noncarriers and 935 untested women). Patients were stratified according to tumor size, and odds ratios were estimated for the presence of positive lymph nodes with increasing tumor size.
A highly significant positive correlation between tumor size and the frequency of positive axillary lymph nodes was seen for BRCA1/BRCA2 noncarriers, for BRCA2 carriers, and for untested women (overall P < 0.0001 for each). In contrast, there was no clear correlation between tumor size and positive lymph node status in BRCA1 carriers (overall P = 0.20).
The relation between tumor size and lymph node status in patients with breast carcinoma appears to be different in BRCA1 carriers compared with BRCA2 carriers and noncarriers. These findings have important implications for estimating the route of metastatic spread and for evaluating the effectiveness of early diagnosis in patients with BRCA1-related breast carcinoma. Cancer 2003. ©2003 American Cancer Society.