Adjuvant chemotherapy of pT1a and pT1b breast carcinoma: results from the NEMESI study

• Published in: BMC cancer Vol. 12; no. 1; p. 158
• Main Authors: Gori, Stefania, Clavarezza, Matteo, Siena, Salvatore, Foglietta, Jennifer, Tarenzi, Emiliana, Giordano, Monica, Molino, Annamaria, Graiff, Claudio, Fusco, Vittorio, Alabiso, Oscar, Baldini, Editta, Gamucci, Teresa, Altavilla, Giuseppe, Dondi, Davide, Venturini, Marco
• Format: Journal Article
• Language: English
• Published: London BioMed Central 30.04.2012; BioMed Central Ltd; BMC
• Subjects: Adjuvant chemotherapy; Adjuvant hormonal therapy; Adjuvant treatment; Adolescent; Adult; Aged; Aged, 80 and over; Anthracyclines; Antineoplastic Agents - therapeutic use; Biomedical and Life Sciences; Biomedicine; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Breast Neoplasms - therapy; Cancer; Cancer Research; Chemotherapy, Adjuvant; Drug therapy; Female; Health Promotion and Disease Prevention; Humans; Medicine/Public Health; Menopause; Middle Aged; Neoplasm Staging; Oncology; Prognosis; pT1a and pT1b breast cancer; Receptor, ErbB-2 - metabolism; Receptors, Estrogen - metabolism; Research Article; Retrospective Studies; Surgical Oncology; Young Adult; Italy; Adjuvant chemotherapy; Adjuvant hormonal therapy; pT1a and pT1b breast cancer
• ISSN: 1471-2407; 1471-2407
• DOI: 10.1186/1471-2407-12-158

Background The prognosis of pT1a-pT1b breast cancer (BC) used to be considered very good, with a 10-y RFS of 90%. However, some retrospective studies reported a 10-y RFS of 81%–86% and suggested benefit from adjuvant systemic therapy. Methods To evaluate the variables that determined the choice of adjuvant chemotherapy and the type of chemotherapy delivered in pT1a-pT1b BC, we analysed the small tumours enrolled in the NEMESI study. Results Out of 1,894 patients with pathological stage I-II BC enrolled in NEMESI, 402 (21.2%) were pT1a-pT1b. Adjuvant chemotherapy was delivered in 127/402 (31.59%). Younger age, grading G3, high proliferative index, ER-negative and HER2-positive status were significantly associated with the decision to administer adjuvant chemotherapy. An anthracycline without taxane regimen was administered in 59.1% of patients, anthracycline with taxane in 24.4%, a CMF-like regimen in 14.2% and taxane in 2.4%. Adjuvant chemotherapy was administered in 88.4% triple-negative and 73.46% HER2-positive pT1a-pT1b BC. Adjuvant trastuzumab was delivered in 30/49 HER2-positive BC (61.2%). Conclusions Adjuvant chemotherapy was delivered in 31.59% T1a-pT1b BC treated at 63 Italian oncological centres from January 2008 to June 2008. The choice to deliver chemotherapy was based on biological prognostic factors. Anthracycline-based chemotherapy was administered in 83.5% patients.