Triple negativity and young age as prognostic factors in lymph node-negative invasive ductal carcinoma of 1 cm or less

We performed a retrospective analysis of clinical and pathology data of all consecutive patients with node-negative T1mic, T1a, and T1b invasive ductal carcinoma who received surgery between Jan 2000 and Dec 2006. The recurrence free survival (RFS) and risk factors for recurrence were identified.Out of 3889 patients diagnosed with breast cancer, 375 patients were enrolled (T1mic:120, T1a:93, T1b:162). Median age at diagnosis was 49. After a median follow up of 60.8 months, 12 patients developed recurrences (T1mic:4 (3.3%), T1a:2 (2.2%), T1b:6 (3.7%)), with a five-year cumulative RFS rate of 97.2%. Distant recurrence was identified in three patients. Age younger than 35 years (HR 4.91; 95% CI 1.014-23.763, p = 0.048) and triple negative disease (HR 4.93; 95% CI 1.312-18.519, p = 0.018) were significantly associated with a higher rate of recurrence. HER2 overexpression, Ki-67, and p53 status did not affect RFS.Prognosis of node-negative breast cancer with T1mic, T1a and T1b is excellent, but patients under 35 years of age or with triple negative disease have a relatively high risk of recurrence.Owing to the increased use of screening mammography, the proportion of early stage breast cancer is increasing internationally [1-3]. In Korea, an increase in the percentage of stage 0 and I types of breast cancer has also been reported. The proportion of stage 0 breast cancer was 7.5% in 2002 and increased to 11.3% in 2003. For stage I breast cancer, the proportion of patients increased from 29.5% to 36.5% over the same period [4,5].Generally, it has been reported that the prognosis of small-sized, node-negative breast cancer is excellent with complete surgical resection of the primary tumor, even without systemic adjuvant therapy [6]. For patients with microinvasive breast cancer, which is defined as tumor foci of 0.1 cm or less, a very small percentage of women relapse or die of breast cancer [7]. According to an analysis of the Surveillance Epidemiology and End Results (SEE