Hormone receptors and HER-2 status as surrogates for breast cancer molecular subtypes prognosticate for disease control in node negative Asian patients treated with breast conservation therapy
Autor: | Fuh Yong Wong, Francis KC Chin, Kuo Ann Lee, Yoke Lim Soong, Eu Tiong Chua |
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Rok vydání: | 2011 |
Předmět: |
Adult
Aged 80 and over Receptor ErbB-2 Breast Neoplasms General Medicine Middle Aged Mastectomy Segmental Prognosis Risk Assessment Survival Analysis Treatment Outcome Receptors Estrogen Multivariate Analysis Humans Female Radiotherapy Adjuvant Neoplasm Recurrence Local Receptors Progesterone Aged Retrospective Studies |
Zdroj: | Annals of the Academy of Medicine, Singapore. 40(2) |
ISSN: | 0304-4602 |
Popis: | Introduction: Our study investigates whether an approximation of breast cancer molecular subtypes using the hormone receptors and HER-2 status prognosticates for disease control after breast conservation therapy (BCT) in node-negative Asian breast cancer patients. Methods and Materials: We retrospectively reviewed 541 women with node-negative breast cancers treated with BCT between 1989 and 2007. Hormone receptors and HER-2 status were obtained from patients’ histological report. All patients received radiotherapy. Thirty-six percent and 68% of women received chemotherapy and hormonal treatment respectively. Results: Median follow-up of patients is 72 months. Five-year local recurrence free survival (LRFS) is 97.2% for the cohort but differs between subtypes: luminal A, 0.8%; luminal B, 1.4%; HER-2, 3.6% and basal-like, 12.7% (P = 0.047). The 5-year distant disease free survival (DDFS) is 96.4% for the cohort but differs between subtypes: luminal A, 98.2%; luminal B, 92.6%; HER-2, 89.5% and basal-like, 91.5% (P = 0.019). The 5-year disease free survival (DFS) is 94.4% for the cohort but differs between subtypes: luminal A, 97.4%; luminal B, 92.7%; HER-2, 86.3% and basal-like, 85.0% (P = 0.007). Univariate analysis with luminal A as baseline revealed an association of the other 3 subtypes with decreased DFS (P = 0.007), Hazard Ratio (HR) of 2.2, 4.4 and 3.3 to Luminal B, HER-2 and basal subtypes, respectively. On multivariate analysis, HER-2 subtype (AHR = 3.3, 95% CI, 1.1 to 9.8, P = 0.036) and basal-like subtype (HR = 3.5, 95% CI, 1.2 to 9.9, P = 0.019) prognosticate adversely for DFS. Conclusion: The combination of hormone receptors and HER-2 status can be used as surrogates for molecular subtypes in Asian breast cancer patients with node-negative disease to prognosticate LRFS, DFS and DDFS. Keywords: Histological subtypes, Lumpectomy, Outcomes, Prognostic factors |
Databáze: | OpenAIRE |
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