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. 2010;15(12):1248-52.
doi: 10.1634/theoncologist.2010-0123. Epub 2010 Dec 8.

Nonpalpable breast carcinomas: long-term evaluation of 1,258 cases

Umberto Veronesi  1 , Alberto Luini, Edoardo Botteri, Stefano Zurrida, Simonetta Monti, Viviana Galimberti, Enrico Cassano, Antuono Latronico, Maria Pizzamiglio, Giuseppe Viale, Dario Vezzoli, Nicole Rotmensz, Simona Musmeci, Fabio Bassi, Loredana Burgoa, Patrick Maisonneuve, Giovanni Paganelli, Paolo Veronesi
Affiliations

Nonpalpable breast carcinomas: long-term evaluation of 1,258 cases

Umberto Veronesi et al. Oncologist. 2010.

Abstract

Introduction: In recent decades, a steady improvement in imaging diagnostics has been observed together with a rising adherence to regular clinical breast examinations. As a result, the detection of small clinically occult (nonpalpable) lesions has progressively increased. At present in our institution some 20% of the cases are treated when nonpalpable. The aim of the present study is to analyze the characteristics and prognosis of such tumors treated in a single institution.

Methods: The analysis focused on 1,258 women who presented at the European Institute of Oncology with a primary clinically occult carcinoma between 2000 and 2006. All patients underwent radioguided occult lesion localization (ROLL), axillary dissection when appropriate, whole breast radiotherapy, or partial breast intraoperative irradiation and received tailored adjuvant systemic treatment.

Results: Median age was 56 years. Imaging showed a breast nodule in half of the cases and a breast nodule accompanied by microcalcifications in 9%. Microcalcifications alone were present in 17.1% of the cases, whereas suspicious opacity, distortion, or thickening represented the remaining 24.6%. Most tumors were characterized by low proliferative rates (68.9%), positive estrogen receptors (92.3%), and non-overexpressed Her2/neu (91.3%). After a median follow-up of 60 months, we observed 19 local events (1.5%), 12 regional events (1%), and 20 distant metastases (1.6%). Five-year overall survival was 98.6%.

Conclusions: Clinically occult (nonpalpable) carcinomas show very favorable prognostic features and high survival rates, showing the important role of modern imaging techniques.

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Conflict of interest statement

Disclosures: Umberto Veronesi: None; Alberto Luini: None; Edoardo Botteri: None; Stefano Zurrida: None; Simonetta Monti: None; Viviana Galimberti: None; Enrico Cassano: None; Antuono Latronico: None; Maria Pizzamiglio: None; Giuseppe Viale: None; Dario Vezzoli: None; Nicole Rotmensz: None; Simona Musmeci: None; Fabio Bassi: None; Loredana Burgoa: None; Patrick Maisonneuve: None; Giovanni Paganelli: None; Paolo Veronesi: None.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the authors or independent peer reviewers.

Figures

Figure 1.
Figure 1.
Cumulative incidence of local events.
Figure 2.
Figure 2.
Overall survival.
See this image and copyright information in PMC

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