Effect of Paget's disease on survival in breast cancer: an exploratory study
Authors
Ortiz-Pagan, SoniaCunto-Amesty, Gina
Narayan, Sandeep
Crawford, Sybil L.
Derrick, Chase
Larkin, Anne C.
Khan, Ashraf
Quinlan, Robert M.
Layeequr Rahman, Rakhshanda
UMass Chan Affiliations
Department of Medicine, Division of Preventive and Behavioral MedicineDepartment of Pathology
Department of Surgery
Document Type
Journal ArticlePublication Date
2011-11-23Keywords
Breast NeoplasmsDisease-Free Survival
Female
Follow-Up Studies
Humans
Massachusetts
Middle Aged
Neoplasm Staging
Paget's Disease, Mammary
Prognosis
Retrospective Studies
Risk Factors
*SEER Program
Survival Rate
Neoplasms
Pathology
Public Health
Surgery
Metadata
Show full item recordAbstract
OBJECTIVE: To explore whether Paget's disease (PD) has an effect on outcome in patients with breast cancer. DESIGN: Retrospective analysis of comprehensive pathology database, medical records, and slides of samples showing pathologic features. SETTING: UMass Memorial Health Care. PATIENTS: All patients with breast cancer and PD with records in a prospectively maintained database between January 1, 1990, and December 31, 2008, were identified. Each participant was matched (criteria: age within 5 years, year of treatment, and stage of breast cancer) with 2 controls (1:2 ratio). MAIN OUTCOME MEASURES: Overall and disease-free survival were analyzed using Kaplan-Meier statistics and Cox proportional hazards modeling, accounting for matching in the latter analyses by using robust standard error estimates. RESULTS: Mean (SD) follow-up was 47 (33) months. Treatment involved mastectomy in 29 (91%) PD vs 16 (25%) non-PD patients (P < .001), radiotherapy in 14 (44%) PD vs 53 (83%) non-PD patients (P < .001), and hormonal therapy in 14 (44%) PD vs 33 (52%) non-PD patients (P = .004). Biological markers were not significantly different except for ERBB2 (formerly HER2 or HER2/neu) overexpression in 14 (44%) PD vs 16 (25%) non-PD patients (P = .008). The PD group had an overall 5-year survival of 81.2% vs 93.8% of the non-PD group (Kaplan-Meier log-rank, P = .03). The unadjusted hazard ratio for the PD vs non-PD group was 5.31 (95% CI, 1.74-16.27; P = .003). The corresponding hazard ratio after adjusting for local and systemic treatment was 2.26 (95% CI, 0.46-11.06; P = .32). CONCLUSIONS: These exploratory data show that PD may have a negative effect on breast cancer survival. This finding needs to be substantiated in larger data sets.Source
Arch Surg. 2011 Nov;146(11):1267-70. Link to article on publisher's siteDOI
10.1001/archsurg.2011.278Permanent Link to this Item
http://hdl.handle.net/20.500.14038/44838PubMed ID
22106318Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1001/archsurg.2011.278