Poor prognosis of single hormone receptor-positive breast cancer: similar outcome as triple-negative breast cancer

被引:128
作者
Bae, Soo Youn [1 ]
Kim, Sangmin [1 ]
Lee, Jun Ho [1 ]
Lee, Hyun-chul [1 ]
Lee, Se Kyung [1 ]
Kil, Won Ho [1 ]
Kim, Seok Won [1 ]
Lee, Jeong Eon [1 ]
Nam, Seok Jin [1 ]
机构
[1] Sungkyunkwan Univ, Sch Med, Dept Surg, Samsung Med Ctr, Seoul 135710, South Korea
关键词
Breast cancer; Estrogen receptor; Progesterone receptor; Human epidermal growth factor receptor 2; Prognosis; ADJUVANT ENDOCRINE THERAPY; PROGESTERONE-RECEPTORS; TUMOR CHARACTERISTICS; ESTROGEN; TAMOXIFEN; IMMUNOHISTOCHEMISTRY; ASSOCIATION; EXPRESSION; CARCINOMA; TRIAL;
D O I
10.1186/s12885-015-1121-4
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Response to endocrine therapy in breast cancer correlates with estrogen receptor (ER) and progesterone receptor (PR) status. Generally, hormone receptor-positive (HR+) breast cancers have favorable prognosis. In order to understand the exact clinical characteristics and prognosis of single HR-positive breast cancer (ER + PR- tumors and ER-PR+ tumors), we compared these tumors to double HR+ tumors as well as HR-negative tumors (ER-PR-). Methods: We examined the clinical and biological features of 6,980 women with invasive ductal carcinoma, and these patients were stratified according to ER and PR expression as double HR+ (ER + PR+), single HR+ (ER + PR-and ER-PR+) and double HR-negative (HR-, ER-PR-) tumors. Results: In this study, 571 (8.2%) cases were single HR+ tumors, of which 90 (1.3%) were ER-PR+ tumors and 481 (6.9%) were ER + PR- tumors. Our multivariate analysis showed that in patients without HER2 overexpression ER + PR- tumors were associated with an increased risk of recurrence and death compared with ER + PR+ tumors, with a hazard ratio of 2.12 for disease-free survival (DFS) and 4.79 for overall survival (OS). In patients without HER2 overexpression ER-PR+ tumors had increased risk of recurrence and death compared with ER + PR+ tumor, with a hazard ratio of 4.19 for DFS and 7.22 for OS. In contrast, in patients with HER2 overexpression, the difference in survival between single HR+ tumors and double HR+ HR-tumors was not statistically significant. In patients without HER2 overexpression the DFS and OS of ER + PR-and ER-PR+ tumors were not significantly different from those of ER-PR-tumors. Conclusion: We have identified clinically and biologically distinct features of single HR+ tumors (ER-PR+ and ER + PR-) through comparison with both ER + PR+ and ER-PR-tumors. These differences were only significant in HER2- tumors, not in HER2+ tumors. Single HR+ tumors without HER2 overexpression (ER + PR-HER2- or ER-PR + HER2-) were associated with poorer survival than ER + PR + HER2- tumors, and had comparable poor survival to ER-PR-HER2- tumors (triple-negative breast cancer).
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页数:9
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