Poor Prognosis of Lower Inner Quadrant in Lymph Node–negative Breast Cancer Patients Who Received No Chemotherapy: A Study Based on Nationwide Korean Breast Cancer Registry Database

Ki Tae Hwang, Jongjin Kim, Eun Kyu Kim, Sung Hoo Jung, Guiyun Sohn, Seung Il Kim, Joon Jeong, Hyouk Jin Lee, Jin Hyun Park, Sohee Oh, Sei Hyun Ahn, Dong Young Noh, Seok Jin Nam, Eun Sook Lee, Byeong Woo Park, Woo Chul Noh, Jung Han Yoon, Soo Jung Lee, Eun Kyu Lee, Joon JeongSehwan Han, Ho Yong Park, Nam Sun Paik, Young Tae Bae, Hyouk Jin Lee, Heung Kyu Park, Seung Sang Ko, Byung Joo Song, Young Jin Suh, Sung Hoo Jung, Se Heon Cho, Sei Joong Kim, Se Jeong Oh, Byung Kyun Ko, Ku Sang Kim, Chanheun Park, Jong Min Baek, Ki Tae Hwang, Il Sung Chang, Jeoung Won Bae, Jeong Soo Kim, Sun Hee Kang, Geumhee Gwak, Jee Hyun Lee, Tae Hyun Kim, Myungchul Chang, Sung Yong Kim, Jung Sun Lee, Jeong Yoon Song, Hai Lin Park, Sun Young Min, Jung Hyun Yang, Sung Hwan Park, Woo Chan Park, Lee Su Kim, Dong Won Ryu, Kweon Cheon Kim, Min Sung Chung, Hee Boong Park, Cheol Wan Lim, Un Jong Choi, Beom Seok Kwak, Young Sam Park, Hyuk Jai Shin, Young Jin Choi, Doyil Kim, Airi Han, Jong Hyun Koh, Sangyong Choi, Daesung Yoon, Soo Youn Choi, Shin Hee Chul, Jae Il Kim, Jae Hyuck Choi, Jin Woo Ryu, Chang Dae Ko, Il Kyun Lee, Dong Seok Lee, Seunghye Choi, Youn Ki Min, Young San Jeon, Eun Hwa Park

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Abstract

The influence of primary tumor site on the prognosis of breast cancer is not consistent but still controversial. We analyzed data of 63,388 patients with primary breast cancer from the Korean Breast Cancer Registry. Lower inner quadrant showed a worse prognosis despite having more favorable clinicopathologic features than other tumor locations and it was more prominent for lymph node–negative patients who received no chemotherapy. Background We aimed to investigate the prognostic influence of primary tumor site on the survival of patients with breast cancer. Patients and Methods Data of 63,388 patients with primary breast cancer from the Korean Breast Cancer Registry were analyzed. Primary tumor sites were classified into 5 groups: upper outer quadrant, lower outer quadrant, upper inner quadrant, lower inner quadrant (LIQ), and central portion. We analyzed overall survival (OS) and breast cancer–specific survival (BCSS) according to primary tumor site. Results Central portion and LIQ showed lower survival rates regarding both OS and BCSS compared with the other 3 quadrants (all P < .05) and hazard ratios were 1.267 (95% CI, 1.180-1.360, P < .001) and 1.215 (95% CI, 1.097-1.345, P < .001), respectively. Although central portion showed more unfavorable clinicopathologic features, LIQ showed more favorable features than the other 3 quadrants. Primary tumor site was a significant factor in univariate and multivariate analyses for OS and BCSS (all P < .001). For lymph node–negative patients, LIQ showed a worse OS than the other primary tumor sites in the subgroup with no chemotherapy (P < .001), but that effect disappeared in the subgroup with chemotherapy (P = .058). Conclusion LIQ showed a worse prognosis despite having more favorable clinicopathologic features than other tumor locations and it was more prominent for lymph node–negative patients who received no chemotherapy. The hypothesis of possible hidden internal mammary node metastasis could be suggested to play a key role in LIQ lesions.

Original languageEnglish
Pages (from-to)e169-e184
JournalClinical Breast Cancer
Volume17
Issue number4
DOIs
Publication statusPublished - 2017 Jul

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All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Hwang, K. T., Kim, J., Kim, E. K., Jung, S. H., Sohn, G., Kim, S. I., Jeong, J., Lee, H. J., Park, J. H., Oh, S., Ahn, S. H., Noh, D. Y., Nam, S. J., Lee, E. S., Park, B. W., Noh, W. C., Yoon, J. H., Lee, S. J., Lee, E. K., ... Park, E. H. (2017). Poor Prognosis of Lower Inner Quadrant in Lymph Node–negative Breast Cancer Patients Who Received No Chemotherapy: A Study Based on Nationwide Korean Breast Cancer Registry Database. Clinical Breast Cancer, 17(4), e169-e184. https://doi.org/10.1016/j.clbc.2016.12.011