Browse > Article
http://dx.doi.org/10.7314/APJCP.2014.15.1.315

HER2-enriched Tumors Have the Highest Risk of Local Recurrence in Chinese Patients Treated with Breast Conservation Therapy  

Jia, Wei-Juan (Department of breast cancer, Sun Yat-sen Memorial Hospital, Sun Yat-sen University)
Jia, Hai-Xia (Department of breast cancer, Sun Yat-sen Memorial Hospital, Sun Yat-sen University)
Feng, Hui-Yi (Department of breast cancer, Sun Yat-sen Memorial Hospital, Sun Yat-sen University)
Yang, Ya-Ping (Department of breast cancer, Sun Yat-sen Memorial Hospital, Sun Yat-sen University)
Chen, Kai (Department of breast cancer, Sun Yat-sen Memorial Hospital, Sun Yat-sen University)
Su, Feng-Xi (Department of breast cancer, Sun Yat-sen Memorial Hospital, Sun Yat-sen University)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.15, no.1, 2014 , pp. 315-320 More about this Journal
Abstract
Purpose: The purpose of this study was to investigate the recurrence pattern and characteristics of patients based on the 2013 St. Gallen surrogate molecular subtypes after breast-conserving surgery (BCS) in Chinese women. Methods: This retrospective analysis included 709 consecutive breast cancer patients undergoing BCS from 1999-2010 at our institution. Five different surrogate subtypes were created using combined expression of the estrogen receptor, progesterone receptor, and human epidermal growth factor receptor-2. Locoregional relapse-free survival (LRRFS), distant metastasis-free survival (DMFS), and disease-free survival (DFS) rates were calculated. Results: The 5-year LRRFS, DMFS, and DFS rates were 90.5%, 88.2%, and 81.5%, respectively. Multivariate analysis revealed that young age, node-positive disease, and HER2 enrichment were independent prognostic factors in LRRFS patients. There was also an independent prognostic role of lymph node-positive disease in DMFS and DFS patients. Patients with luminal A tumors had the most favorable prognosis, with LRRFS, DMFS, and DFS rates of 93.2%, 91.5%, and 87.4% at 5 years, respectively. Conversely, HER-2-enriched tumors exhibited the highest rate of locoregional recurrence (20.6%). Conclusion: Surrogate subtypes present with significant differences in RFS, DMFS, and LRRFS. Luminal A tumors have the best prognosis, whereas HER2-enriched tumors have the poorest.
Keywords
Breast cancer; recurrence; molecular subtype; breast-conserving surgery;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Yang H, Jia W, Chen K, et al (2012), Cavity margins and lumpectomy margins for pathological assessment: which is superior in breast-conserving surgery?. J Surg Res, 178, 751-7.   DOI   ScienceOn
2 van der Leij F, Elkhuizen PH, Bartelink H, van de Vijver MJ (2012), Predictive factors for local recurrence in breast cancer. Semin Radiat Oncol, 22, 100-7.   DOI   ScienceOn
3 Veronesi U, Cascinelli N, Mariani L, et al (2002), Twentyyear follow-up of a randomized study comparing breastconserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347, 1227-32.   DOI   ScienceOn
4 Voduc KD, Cheang MC, Tyldesley S, et al (2010), Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol, 28 1684-91.   DOI   ScienceOn
5 Yau TK, Soong IS, Chan K, et al (2007), Clinical outcome of breast conservation therapy for breast cacner in Hong Kong: prognostic impact of ipsilateral breast tumor recurrence and 2005 St. Gallen risk categories. Int J Radiat Oncol Biol Phys, 68, 667-72.   DOI   ScienceOn
6 Li S, Yu KD, Fan L, Hou YF, Shao ZM (2011), Predicting breast cancer recurrence following breast-conserving therapy: a single-institution analysis consisting of 764 Chinese breast cancer cases. Ann Surg Oncol, 18, 2492-9.   DOI   ScienceOn
7 Kim KJ, Huh SJ, Yang JH, et al (2005), Treatment results and prognostic factors of early breast cancer treated with a breast conserving operation and radiotherapy. Jpn J Clin Oncol, 35, 126-33.   DOI   ScienceOn
8 Hsu JL, Glaser SL, West DW (1997), Racial/ethnic differences in breast cancer survival among San Francisco Bay Area women. J Natl Cancer Inst, 89, 1311-2.   DOI   ScienceOn
9 Li J, Zhang BN, Fan JH, et al (2011), A nation-wide multicenter 10-year (1999-2008) retrospective clinical epidemiological study of female breast cancer in China. BMC Cancer, 11, 364.   DOI
10 Miles RC, Gullerud RE, Lohse CM, et al (2012), Local recurrence after breast-conserving surgery: multivariable analysis of risk factors and the impact of young age. Ann Surg Oncol, 19, 1153-9.   DOI   ScienceOn
11 Millar EK, Graham PH, O'Toole SA, et al (2009), Prediction of local recurrence, distant metastases, and death after breast-conserving therapy in early-stage invasive breast cancer using a five-biomarker panel. J Clin Oncol, 27, 4701-8.   DOI   ScienceOn
12 Renton SC, Gazet JC, Ford HT, et al (1996), The importance of the resection margin in conservative surgery for breast cancer. Eur J Surg Oncol, 22, 17-22.   DOI   ScienceOn
13 Sorlie T, Perou CM, Tibshirani R, et al (2001), Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA, 98, 10869-74.   DOI   ScienceOn
14 Fisher B, Jeong JH, Anderson S, et al (2002), Twenty-five-year follow-up of a randomized trial comparing radical mastectomy, total mastectomy, and total mastectomy followed by irradiation. N Engl J Med, 347, 567-75.   DOI   ScienceOn
15 Sparano JA, Wang M, Zhao F, et al (2012), Obesity at diagnosis is associated with inferior outcomes in hormone receptorpositive operable breast cancer. Cancer, 118, 5937-46.   DOI   ScienceOn
16 Goldhirsch A, Wood WC, Coates AS, et al (2011), Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol, 22, 1736-47.   DOI   ScienceOn
17 Fisher B, Anderson S, Redmond CK, et al (1995), Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med, 333, 1456-61.   DOI   ScienceOn
18 Forrest AP, Stewart HJ, Everington D, et al (1996), Randomised controlled trial of conservation therapy for breast cancer: 6-year analysis of the Scottish trial. Scottish Cancer Trials Breast Group. Lancet, 348, 703-13.
19 Haffty BG, Yang Q, Reiss M, et al (2006), Locoregional relapse and distant metastasis in conservatively managed triple negative early-stage breast cancer. J Clin Oncol, 24, 5652-7.   DOI   ScienceOn
20 Bland KI, Menck HR, Scott-Conner CE, et al (2009), The National Cancer Data Base 10-year survey of breast carcinoma treatment at hospitals in the United States. Cancer, 83, 1262-73.
21 Jones HA, Antonini N, Hart AA, et al (2009), Impact of pathological characteristics on local relapse after breastconserving therapy: a subgroup analysis of the EORTC boost versus no boost trial. J Clin Oncol, 27, 4939-47.   DOI
22 Chen CH, Lo YF, Tsai HP, et al (2009), Low body mass index is an independent risk factor of locoregional recurrence in women with breast cancer undergoing breast conserving therapy. Chang Gung Med J, 32, 553-62.
23 Kim HJ, Han W, Yi OV, et al (2011), Young age is associated with ipsilateral breast tumor recurrence after breast conserving surgery and radiation therapy in patients with HER2-positive/ER-negative subtype. Breast Cancer Res Treat, 130, 499-505.   DOI
24 Clark RM, Whelan T, Levine M et al (1996), Randomized clinical trial of breast irradiation following lumpectomy and axillary dissection for node-negative breast cancer: an update. Ontario Clinical Oncology Group. J Natl Cancer Inst, 88, 1659-64.   DOI   ScienceOn
25 Brouckaert O, Laenen A, Vanderhaegen J, et al (2012), Applying the 2011 St Gallen panel of prognostic markers on a large single hospital cohort of consecutively treated primary operable breast cancers. Ann Oncol, 23, 2578-84.   DOI
26 Chen K, Zeng YH, Jia W, et al (2012), Clinical outcomes of breast-conserving surgery in patients using a modified method for cavity margin assessment. Ann Surg Oncol, 19, 3386-94.   DOI
27 Cuzick J, Dowsett M, Pineda S, et al (2011), Prognostic value of a combined estrogen receptor, progesterone receptor, Ki-67, and human epidermal growth factor receptor 2 immunohistochemical score and comparison with the Genomic Health recurrence score in early breast cancer. J Clin Oncol, 29, 4273-8.   DOI
28 Dent R, Trudeau M, Pritchard KI, et al (2007), Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res, 13, 4429-34.   DOI   ScienceOn
29 Ewertz M, Jensen MB, Gunnarsdottir KA, et al (2011), Effect of obesity on prognosis after early-stage breast cancer. J Clin Oncol, 29, 25-31.   DOI   ScienceOn
30 Fan L, Zheng Y, Yu KD, et al (2009), Breast cancer in a transitional society over 18 years: trends and present status in Shanghai, China. Breast Cancer Res Treat, 117, 409-16.   DOI
31 Bowen RL, Stebbing J, Jones LJ (2006), A review of the ethnic differences in breast cancer. Pharmacogenomics, 7, 935-42.   DOI   ScienceOn
32 Brenton JD, Carey LA, Ahmed AA, Caldas C (2005), Molecular classification and molecular forecasting of breast cancer: ready for clinical application?. J Clin Oncol, 23, 7350-60.   DOI   ScienceOn