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

Date
2019-10
Authors
Plichta, Jennifer K
Thomas, Samantha M
Sergesketter, Amanda R
Greenup, Rachel A
Fayanju, Oluwadamilola M
Rosenberger, Laura H
Tamirisa, Nina
Hyslop, Terry
Hwang, E Shelley
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Abstract
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.
Type
Journal article
Subject
Breast cancer staging
Clinical stage
Pathological stage
Stage discordance
Permalink
https://hdl.handle.net/10161/19535
Published Version (Please cite this version)
10.1016/j.amjsurg.2019.07.016
Publication Info
Plichta, Jennifer K; Thomas, Samantha M; Sergesketter, Amanda R; Greenup, Rachel A; Fayanju, Oluwadamilola M; Rosenberger, Laura H; ... Hwang, E Shelley (2019). Clinical and pathological stage discordance among 433,514 breast cancer patients. American journal of surgery, 218(4). pp. 669-676. 10.1016/j.amjsurg.2019.07.016. Retrieved from https://hdl.handle.net/10161/19535.
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Scholars@Duke

Fayanju

Oluwadamilola Motunrayo Fayanju

Associate Professor of Surgery
Dr. Fayanju is an Associate Professor of Surgery and Population Health Sciences in the Duke University School of Medicine, Associate Director for Disparities & Value in Healthcare with Duke Forge (the university’s center for actionable data science: https://forge.duke.edu/oluwadamilola-fayanju-md-ma-mphs), and Director of the Durham VA Breast Clinic. She received her undergraduate degree in History and
Greenup

Rachel Adams Greenup

Associate Professor of Surgery
Dr. Greenup is an Associate Professor of Surgery and Population Health Sciences at the Duke School of Medicine and Duke Cancer Institute. She is the founder and co-director of the Duke Breast Cancer Outcomes Research Group, and Core Faculty for the Duke Margolis Center for Health Policy. She earned her undergraduate degrees in Zoology and Psychology at the University of Wisconsin, where she later completed a Masters in Public Health. She attended the Medical College of Wisconsin for M
Hwang

Eun-Sil Shelley Hwang

Mary and Deryl Hart Distinguished Professor of Surgery, in the School of Medicine
Hyslop

Terry Hyslop

Adjunct Professor in the Department of Biostatistics & Bioinformatics
Plichta

Jennifer K Plichta

Associate Professor of Surgery
Dr. Jennifer Plichta is an Associate Professor of Surgery & Population Health Sciences at Duke University. She serves as the Director of the Breast Risk Assessment Clinic in the Duke Cancer Institute, where she cares for patients with breast cancer, benign breast problems, and those with an increased risk of breast cancer. Her clinical interests include establishing routine breast cancer risk assessment for women and creating personalized management strategies for those found to be &ldquo
Rosenberger

Laura Horst Rosenberger

Associate Professor of Surgery
Sergesketter

Amanda Sergesketter

House Staff
Tamirisa

Nina Tamirisa

Clinical Associate in the Department of Surgery
Thomas

Samantha Thomas

Biostatistician, Principal
Samantha is the manager of the Duke Cancer Institute (DCI) Biostatistics Shared Resource. Collaboratively, she primarily works with physicians in DCI, specifically in research of Endocrine Neoplasia and Breast Cancer. She is also the director of the Biostatistics, Epidemiology, Research, and Design Methods (BERD) Core Training and Internship Program (BCTIP). Her professional experience involves study design, analysis, and reporting of clinical trials and observational studies. Her specific areas
Alphabetical list of authors with Scholars@Duke profiles.
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