The association between biological subtype and locoregional recurrence in newly diagnosed breast cancer

被引：78

作者：

Gabos, Zsolt ^{[1
,2
]}

Thoms, John ^{[1
,2
]}

Ghosh, Sunita ^{[2
,3
]}

Hanson, John ^{[2
,3
]}

Deschenes, Jean ^{[2
,4
]}

Sabri, Siham ^{[2
,5
]}

Abdulkarim, Bassam ^{[1
,2
]}

机构：

[1] Cross Canc Inst, Dept Radiat Oncol, Edmonton, AB T6G 1Z2, Canada

[2] Univ Alberta, Edmonton, AB T6G 1Z2, Canada

[3] Cross Canc Inst, Dept Stat & Epidemiol, Edmonton, AB T6G 1Z2, Canada

[4] Cross Canc Inst, Dept Lab Med, Edmonton, AB T6G 1Z2, Canada

[5] Cross Canc Inst, Dept Expt Oncol, Edmonton, AB T6G 1Z2, Canada

来源：

BREAST CANCER RESEARCH AND TREATMENT | 2010年 / 124卷 / 01期

关键词：

Breast cancer; HR-/HER-2+and TN subtype; Locoregional recurrence; CLINICAL-PRACTICE GUIDELINES; GENE-EXPRESSION SIGNATURE; 20-YEAR FOLLOW-UP; ADJUVANT CHEMOTHERAPY; PROGESTERONE-RECEPTOR; MOLECULAR SUBTYPES; CONSERVING SURGERY; ESTROGEN-RECEPTOR; CARE; SURVIVAL;

D O I：

10.1007/s10549-010-1135-1

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

We investigated the association between the risk of locoregional recurrence (LRR) and biological subtypes defined by hormonal receptors (HR) and HER-2 status in women with invasive breast cancer (BC). A total of 618 newly diagnosed BC patients were identified from a cancer registry within a single institution with standardized methods of tumor assessment for estrogen receptor (ER), progesterone receptor (PR), and HER-2. Patients were stratified based on surgical treatment, breast-conserving therapy (BCT) versus modified radical mastectomy (MRM), as well as biological subtypes: HR+/HER-2- (ER-positive or PR-positive, HER-2-negative), HR+/HER-2+ (ER-positive or PR-positive, HER-2-positive), HR-/HER-2+ (ER-negative and PR-negative, HER-2-positive) and TN (ER-negative, PR-negative and HER-2-negative). The association between clinicopathological factors, biological subtype and LRR was evaluated with univariate and multivariate Cox analysis. With a median follow-up of 4.8 years, the rate of LRR was 7.5%. On multivariate analysis, TN, tumor size a parts per thousand yen2 cm and lymph node (LN) positivity were associated with increased risk of LRR (P = 0.023, P = 0.048, and P = 0.0034, respectively). In BCT group, HR-/HER-2+ and LN positivity were associated with increased risk of LRR (HR 11.13; 95% CI 2.78-44.53; P = 0.0007 and HR 5.40; 95% CI 1.67-17.43; P = 0.0048, respectively). In MRM group, TN subtype and LN positivity were associated with increased risk of LRR (HR 4.72; 95% CI 1.53-14.52; P = 0.0069 and HR 3.23; 95% CI 1.44-7.29; P = 0.0047, respectively). Compared to HR+/HER-2-, HR-/HER-2+ treated by BCT and TN treated by MRM showed a significant decrease of 5-year LRR free survival (P = 0.0002 and P = 0.002, respectively). Tumor profiling using ER, PR, and HER-2 biomarkers is a promising tool to identify patients at high risk of LRR based on surgical treatment. Our findings suggest a different follow-up and locoregional treatment for patients with HR-/HER-2+ and TN subtypes.

引用

页码：187 / 194

页数：8

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