TY - JOUR
T1 - Clinical and pathological stage discordance among 433,514 breast cancer patients
AU - Plichta, Jennifer K.
AU - Thomas, Samantha M.
AU - Sergesketter, Amanda R.
AU - Greenup, Rachel A.
AU - Fayanju, Oluwadamilola M.
AU - Rosenberger, Laura H.
AU - Tamirisa, Nina
AU - Hyslop, Terry
AU - Hwang, E. Shelley
N1 - Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/10
Y1 - 2019/10
N2 - Background: We aim to determine clinical and pathological stage discordance rates and to evaluate factors associated with discordance. Methods: Adults with clinical stages I-III breast cancer were identified from the National Cancer Data Base. Concordance was defined as cTN = pTN (discordance: cTN≠pTN). Multivariate logistic regression was used to identify factors associated with discordance. Results: Comparing clinical and pathological stage, 23.1% were downstaged and 8.7% were upstaged. After adjustment, factors associated with downstaging (vs concordance) included grade 3 (OR 10.56, vs grade 1) and HER2-negative (OR 3.79). Factors associated with upstaging (vs concordance) were grade 3 (OR 10.56, vs grade 1), HER2-negative (OR 1.25), and lobular histology (OR 2.47, vs ductal). ER-negative status was associated with stage concordance (vs downstaged or upstaged, OR 0.52 and 0.87). Conclusions: Among breast cancer patients, nearly one-third exhibit clinical-pathological stage discordance. This high likelihood of discordance is important to consider for counseling and treatment planning.
AB - Background: We aim to determine clinical and pathological stage discordance rates and to evaluate factors associated with discordance. Methods: Adults with clinical stages I-III breast cancer were identified from the National Cancer Data Base. Concordance was defined as cTN = pTN (discordance: cTN≠pTN). Multivariate logistic regression was used to identify factors associated with discordance. Results: Comparing clinical and pathological stage, 23.1% were downstaged and 8.7% were upstaged. After adjustment, factors associated with downstaging (vs concordance) included grade 3 (OR 10.56, vs grade 1) and HER2-negative (OR 3.79). Factors associated with upstaging (vs concordance) were grade 3 (OR 10.56, vs grade 1), HER2-negative (OR 1.25), and lobular histology (OR 2.47, vs ductal). ER-negative status was associated with stage concordance (vs downstaged or upstaged, OR 0.52 and 0.87). Conclusions: Among breast cancer patients, nearly one-third exhibit clinical-pathological stage discordance. This high likelihood of discordance is important to consider for counseling and treatment planning.
KW - Breast cancer staging
KW - Clinical stage
KW - Pathological stage
KW - Stage discordance
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U2 - 10.1016/j.amjsurg.2019.07.016
DO - 10.1016/j.amjsurg.2019.07.016
M3 - Article
C2 - 31350005
AN - SCOPUS:85069687493
SN - 0002-9610
VL - 218
SP - 669
EP - 676
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 4
ER -