The Significance of Extent of Extracapsular Extension in Patients with T1-2 and N1 Breast Cancer

Abstract

Objective: The prognostic importance of extracapsular extension (ECE) in breast cancer is not yet clear, especially in patients with pathologicalT1-2 and N1 (pT1-2N1) disease. We aimed to investigate whether the extent of ECE was an independent prognostic factor for survival outcomesin patients with pT1-2N1 breast cancer.Materials and Methods: A total number of 131 patients with pT1-2N1 breast cancer treated between 2009 and 2015 were retrospectively evaluated. A single pathologist re-analyzed the histologic examples of all cases. The extent of ECE was graded from 0 to 4.Results: There was a significant correlation between the number of lymph nodes involved and ECE grade (p=0.004). According to the univariateanalysis, lymphovascular invasion (LVI) and ECE grade were the significant prognostic factors for overall survival (OS); age, number of metastaticlymph nodes, menopausal status, and ECE grade were the prognostic factors for disease-free survival (DFS). With a median follow-up of 46 months,grade 3-4 ECE seems to be notably associated with a shorter OS and DFS in multivariate analysis. The mean OS was 85 months for the patients withgrade 0-2 ECE vs 75 months for the patients with grade 3-4 ECE (p=0.003). The mean DFS was 83 months for the patients with grade 0-3 ECE vs68 months for the patients with grade 4 ECE (p=