Clinical and pathological stage discordance among 433,514 breast cancer patients.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Plichta, JK; Thomas, SM; Sergesketter, AR; Greenup, RA; Fayanju, OM; Rosenberger, LH; Tamirisa, N; Hyslop, T; Hwang, ES

Published Date

  • October 2019

Published In

Volume / Issue

  • 218 / 4

Start / End Page

  • 669 - 676

PubMed ID

  • 31350005

Pubmed Central ID

  • PMC6768746

Electronic International Standard Serial Number (EISSN)

  • 1879-1883

Digital Object Identifier (DOI)

  • 10.1016/j.amjsurg.2019.07.016


  • eng

Conference Location

  • United States