Clinical and pathological stage discordance among 433,514 breast cancer patients - 26/09/19
, Samantha M. Thomas b, c, Amanda R. Sergesketter a, Rachel A. Greenup a, b, Oluwadamilola M. Fayanju a, b, Laura H. Rosenberger a, b, Nina Tamirisa a, Terry Hyslop b, c, E. Shelley Hwang a, bAbstract |
Background |
We aim to determine clinical and pathological stage discordance rates and to evaluate factors associated with discordance.
Methods |
Adults with clinical stages I-III breast cancer were identified from the National Cancer Data Base. Concordance was defined as cTN = pTN (discordance: cTN≠pTN). Multivariate logistic regression was used to identify factors associated with discordance.
Results |
Comparing clinical and pathological stage, 23.1% were downstaged and 8.7% were upstaged. After adjustment, factors associated with downstaging (vs concordance) included grade 3 (OR 10.56, vs grade 1) and HER2-negative (OR 3.79). Factors associated with upstaging (vs concordance) were grade 3 (OR 10.56, vs grade 1), HER2-negative (OR 1.25), and lobular histology (OR 2.47, vs ductal). ER-negative status was associated with stage concordance (vs downstaged or upstaged, OR 0.52 and 0.87).
Conclusions |
Among breast cancer patients, nearly one-third exhibit clinical-pathological stage discordance. This high likelihood of discordance is important to consider for counseling and treatment planning.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Clinical and pathological stage discordance occurred in 31.8% of patients. |
• | Upstaging occurred in 8.7% and downstaging in 23.1%. |
• | Tumor grade, histology and biomarker status were associated with stage discordance. |
Résumé |
Among individuals with stages I-III breast cancer not treated with neoadjuvant therapy, discordance between clinical and pathological staging occurred in 31.8% of patients, with upstaging in 8.7% and downstaging in 23.1%. Factors most highly associated with stage discordance were tumor grade, histology, and biomarker status.
Le texte complet de cet article est disponible en PDF.Keywords : Breast cancer staging, Clinical stage, Pathological stage, Stage discordance
Plan
Vol 218 - N° 4
P. 669-676 - octobre 2019 Retour au numéro
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