Palpable breast cancers are inherently different from nonpalpable breast cancers

Background: We examined the clinicopathologic profile of T1 cancers to dete rmine whether palpable cancers are different from nonpalpable cancers. Methods: A prospective database was reviewed. Palpable TI cancers were comp ared with nonpalpable TI cancers. Initial significance was determined by ch i (2) analysis. Factors found to be significant were then reanalyzed, contr olling for tumor size by logistic or linear regression, as appropriate. Results: Of 1263 TI cancers treated between 1981 and 2000, 857 (68%) were p alpable and 401 (32%) were nonpalpable. Palpability correlated with patholo gic tumor size, mitotic grade, nuclear grade, high S-phase, lymphovascular invasion, nodal positivity, and lack of extensive intraductal component, mu ltifocality, and multicentricity. There was no significant difference in es trogen receptor, progesterone receptor or Her-2/neu status, ploidy, or DNA index. Breast cancer-specific survival was worse for patients with palpable cancers. Conclusions: Palpable cancers are inherently different from nonpalpable can cers, with a less diffuse growth pattern, higher metastatic potential, high er proliferative activity, more nuclear abnormalities, and a worse prognosi s.