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Annals of Surgical Oncology 8:705-710 (2001)
© 2001 Society of Surgical Oncology

ORIGINAL ARTICLES

Palpable Breast Cancers Are Inherently Different From Nonpalpable Breast Cancers

Kristin A. Skinner, MD, Howard Silberman, MD, Richard Sposto, PhD and Melvin J. Silverstein, MD

From the Departments of Surgery (KAS, HS) and Preventive Medicine (RS), Norris Comprehensive Cancer Center, Keck School of Medicine, The University of Southern California, Los Angeles, California.

Correspondence: Address correspondence and reprint requests to: Kristin A. Skinner, MD, Norris Comprehensive Cancer Center, 1441 Eastlake Avenue, MS74, Los Angeles, CA 90033; Fax: 323-865-0119; E-mail: kskinner{at}hsc.usc.edu

Background: We examined the clinicopathologic profile of T1 cancers to determine whether palpable cancers are different from nonpalpable cancers.

Methods: A prospective database was reviewed. Palpable T1 cancers were compared with nonpalpable T1 cancers. Initial significance was determined by {chi}2 analysis. Factors found to be significant were then reanalyzed, controlling for tumor size by logistic or linear regression, as appropriate.

Results: Of 1263 T1 cancers treated between 1981 and 2000, 857 (68%) were palpable and 401 (32%) were nonpalpable. Palpability correlated with pathologic tumor size, mitotic grade, nuclear grade, high S-phase, lymphovascular invasion, nodal positivity, and lack of extensive intraductal component, multifocality, and multicentricity. There was no significant difference in estrogen receptor, progesterone receptor or Her-2/neu status, ploidy, or DNA index. Breast cancer-specific survival was worse for patients with palpable cancers.

Conclusions: Palpable cancers are inherently different from nonpalpable cancers, with a less diffuse growth pattern, higher metastatic potential, higher proliferative activity, more nuclear abnormalities, and a worse prognosis.

Key Words: Palpable • Nonpalpable • Breast cancer • Clinicopathologic features






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