pISSN 1738-6756   eISSN 2092-9900
Open Access, Peer-reviewed
    J Breast Cancer. 2009 Dec;12(4):316-323. Korean.
    Published online Dec 31, 2009.
    https://doi.org/10.4048/jbc.2009.12.4.316
    Copyright © 2009 Korean Breast Cancer Society
    Original Article

    The Influence of Breast Volume on Prognosis of Primary Breast Cancer with Same T Stage

    Jung Jae Lee, Young San Jeon, Su Hwan Kang and Soo Jung Lee
      • Department of Surgery, Yeungnam University College of Medicine, Daegu, Korea.
    • Corresponding author (Email: crystallee@medical.yu.ac.kr )
    Received July 21, 2009; Accepted August 25, 2009.

    Abstract

    Purpose

    The aim of this study was to evaluate the prognostic significance of the breast volume in primary breast cancer patients with the same T stage.

    Methods

    The study population consisted of 358 patients with T1 and T2 primary breast cancer, who underwent preoperative mammography and surgery in our institution from March 1992 to December 2006. The patients were divided into three groups based on the calculated breast volume as the following: Group A: <285 cc (n=117), Group B: 285-460 cc (n=121) and Group C: ≥460 cc (n=120). Overall survival (OS) and disease free survival (DFS) of the patients in the three groups in each T stage were analyzed.

    Results

    The mean age was 46.3 years (age range, 22-85 years) and the mean calculated breast volume was 403.1 cc (volume range, 94-1,231 cc). As the age of patients was increased, the breast volume was increased (r=0.184, p<0.001). With a mean follow up period of 80.8 months, there was no significant difference in DFS or OS among patients in Groups A, B, and C (p>0.05). For patients with T1 stage disease, Group A patients showed the highest DFS and OS, and patients in Group C showed the lowest DFS and OS; however, the difference was not statistically significant (p>0.05). For patients with T2 disease, patients in Group C showed the highest DFS and OS, though the difference with the two other groups did not have statistical significance (p>0.05).

    Conclusion

    The breast volume was not a significant predictor of DFS and OS for patients with T1 and T2 breast cancer. However it should be noted that this was the first study to evaluate the correlation between breast volume and survival in breast cancer patients.

    Keywords
    Breast; Carcinoma; Organ size; Prognosis

    Figures

    Figure 1
    The breast volume is calculated by use of the formula for the volume of a half-elliptic cylinder as derived from a craniocaudal view from a mammogram.

    C=compression thickness; H=posterior-to-anterior height; W=medial-to-lateral width.

    Figure 2
    Bivariate correlation analysis between breast volume (as determined by mammogram) and patient's age (A) and body mass index (B). (A) There was only a weak correlation between breast volume and patient's age. (B) There was a strong correlation between breast volume and body mass index.

    Figure 3
    Disease-free survival and overall survival curve according to breast volume. There were no significant survival differences.

    Figure 4
    Disease-free survival and overall survival curve of T1 (A, B) and T2 (C, D) breast cancer patients according to breast volume. There were no significant survival differences in all subgroups.

    Tables

    Table 1
    Characteristics of the patients

    Table 2
    p-values of breast volume related overall survival rate and disease free survival rate

    Table 3
    p-values of breast volume related overall survival rate and disease free survival rate in patients with normal range of body mass index

    Table 4
    The relation of breast volume with prognostic factor of breast cancer

    References

      1. Hoe AL, Mullee MA, Royle GT, Guyer PB, Taylor I. Breast size and prognosis in early breast cancer. Ann R Coll Surg Engl 1993;75:18–22.
      1. Kato I, Beinart C, Bleich A, Su S, Kim M, Toniolo PG. A nested case-control study of mammographic patterns, breast volume, and breast cancer (New York City, NY, United States). Cancer Causes Control 1995;6:431–438.
      1. Scutt D, Manning JT, Whitehouse GH, Leinster SJ, Massey CP. The relationship between breast asymmetry, breast size and the occurrence of breast cancer. Br J Radiol 1997;70:1017–1021.
      1. Hsieh CC, Trichopoulos D. Breast size, handedness and breast cancer risk. Eur J Cancer 1991;27:131–135.
      1. Wynder EL, Bross IJ, Hirayama T. A study of the epidemiology of cancer of the breast. Cancer 1960;13:559–601.
      1. Kusano AS, Trichopoulos D, Terry KL, Chen WY, Willett WC, Michels KB. A prospective study of breast size and premenopausal breast cancer incidence. Int J Cancer 2006;118:2031–2034.
      1. Morimoto LM, White E, Chen Z, Chlebowski RT, Hays J, Kuller L, et al. Obesity, body size, and risk of postmenopausal breast cancer: the Women's Health Initiative (United States). Cancer Causes Control 2002;13:741–751.
      1. Vatten LJ, Kvinnsland S. Body height and risk of breast cancer. a prospective study of 23,831 Norwegian women. Br J Cancer 1990;61:881–885.
      1. Byrne C, Schairer C, Wolfe J, Parekh N, Salane M, Brinton LA, et al. Mammographic features and breast cancer risk: effects with time, age, and menopause status. J Natl Cancer Inst 1995;87:1622–1629.
      1. Carter CL, Allen C, Henson DE. Relation of tumor size, lymph node status, and survival in 24,740 breast cancer cases. Cancer 1989;63:181–187.
      1. Hilsenbeck SG, Ravdin PM, de Moor CA, Chamness GC, Osborne CK, Clark GM. Time-dependence of hazard ratios for prognostic factors in primary breast cancer. Breast Cancer Res Treat 1998;52:227–237.
      1. Fisher B, Slack NH. Number of lymph nodes examined and the prognosis of breast carcinoma. Surg Gynecol Obstet 1970;131:79–88.
      1. Crowe JP Jr, Gordon NH, Hubay CA, Shenk RR, Zollinger RM, Brumberg DJ, et al. Estrogen receptor determination and long term survival of patients with carcinoma of the breast. Surg Gynecol Obstet 1991;173:273–278.
      1. Contesso G, Mouriesse H, Friedman S, Genin J, Sarrazin D, Rouesse J. The importance of histologic grade in long-term prognosis of breast cancer: a study of 1,010 patients, uniformly treated at the Institut Gustave-Roussy. J Clin Oncol 1987;5:1378–1386.
      1. Fisher ER, Sass R, Fisher B. Pathologic findings from the National Surgical Adjuvant Project for Breast Cancers (protocol no. 4). X. Discriminants for tenth year treatment failure. Cancer 1984;53 3 Suppl:712–723.
      1. Diab SG, Clark GM, Osborne CK, Libby A, Allred DC, Elledge RM. Tumor characteristics and clinical outcome of tubular and mucinous breast carcinomas. J Clin Oncol 1999;17:1442–1448.
      1. Nixon AJ, Neuberg D, Hayes DF, Gelman R, Connolly JL, Schnitt S, et al. Relationship of patient age to pathologic features of the tumor and prognosis for patients with stage I or II breast cancer. J Clin Oncol 1994;12:888–894.
      1. Andrulis IL, Bull SB, Blackstein ME, Sutherland D, Mak C, Sidlofsky S, et al. Toronto Breast Cancer Study Group. neu/erbB-2 amplification identifies a poor-prognosis group of women with node-negative breast cancer. J Clin Oncol 1998;16:1340–1349.
      1. Lesar M, Stanec M, Banovic M. Significance of the relative size of a breast tumor in deciding the method of surgical treatment. Tumori 2006;92:18–20.
      1. Katariya RN, Forrest AP, Gravelle IH. Breast volumes in cancer of the breast. Br J Cancer 1974;29:270–273.
      1. Hyndman RJ, Fan Y. Sample quantiles in statistical packages. Am Stat 1996;50:361–365.
      1. Scutt D, Lancaster GA, Manning JT. Breast asymmetry and predisposition to breast cancer. Breast Cancer Res 2006;8:R14.
      1. Fowler PA, Casey CE, Cameron GG, Foster MA, Knight CH. Cyclic changes in composition and volume of the breast during the menstrual cycle, measured by magnetic resonance imaging. Br J Obstet Gynaecol 1990;97:595–602.
      1. Riedl CC, Ponhold L, Flöry D, Weber M, Kroiss R, Wagner T, et al. Magnetic resonance imaging of the breast improves detection of invasive cancer, preinvasive cancer, and premalignant lesions during surveillance of women at high risk for breast cancer. Clin Cancer Res 2007;13:6144–6152.
      1. Fisher B, Bauer M, Margolese R, Poisson R, Pilch Y, Redmond C, et al. Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer. N Engl J Med 1985;312:665–673.
      1. Fisher B, Redmond C, Poisson R, Margolese R, Wolmark N, Wickerham L, et al. Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 1989;320:822–828.
      1. Vitucci C, Tirelli C, Graziano F, Santoro E. Results of conservative surgery for limited-sized infiltrating breast cancer: analysis of 962 tested patients: 24 years of experience. J Surg Oncol 2000;74:108–115.
      1. Bulstrode N, Bellamy E, Shrotria S. Breast volume assessment: comparing five different techniques. Breast 2001;10:117–123.
      1. Kalbhen CL, McGill JJ, Fendley PM, Corrigan KW, Angelats J. Mammographic determination of breast volume: comparing different methods. AJR Am J Roentgenol 1999;173:1643–1649.
    MeSH Terms
    Breast
    Breast Neoplasms
    Disease-Free Survival
    Follow-Up Studies
    Humans
    Mammography
    Organ Size
    Prognosis
    Metrics
    Share
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    Tables
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