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Liu X, Liu Z, Li C, Song X, Wang X, Li S, Yu Z. PR status is a more decisive factor in efficacy of adding pertuzumab into neoadjuvant therapy for HER2-positive and lymph node-positive breast cancer than ER status: a real-world retrospective study in China. World J Surg Oncol 2023; 21:296. [PMID: 37723497 PMCID: PMC10506239 DOI: 10.1186/s12957-023-03178-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/09/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Although neoadjuvant trastuzumab and pertuzumab (HP)-based regimens are recommended for human epidermal receptor-positive (HER2 +)/lymph node-positive (N +) breast cancer (BC) patients according to NCCN guidelines, it is undeniable that many patients achieved pathological complete response (pCR) after trastuzumab (H)-based regimens without adding pertuzumab to treatment. Patients who specifically benefit from pertuzumab must be identified. The aim of this retrospective study was to evaluate progesterone receptor (PR) status as a predictor of response to the addition of pertuzumab in HER2 + /N + breast cancer. METHODS One hundred forty-two patients who were diagnosed as HER2 + /N + BC without distant metastasis and followed by neoadjuvant HP-based or H-based therapy were retrospectively included. The endpoints were pCR and disease-free survival (DFS) times. RESULTS In total, the pCR occurred in 25 of 87 patients (28.74%) in group H compared with 32 of 55 (58.18%) in group HP. The results revealed that hormone receptor (HR) status was significantly different on pCR in group HP. The odds of pCR for patients who have HR-positive tumors were 0.160 times (P = 0.011) that for patients with HR-negative tumors by multivariable analysis. Moreover, a similar probability of PR-positive (PR +) patients, whatever estrogen receptor (ER) status was, achieving pCR in group HP was observed. The ROC curves showed different anti-HER2 regimens provide worst predictive value in the PR + cohort (N = AUC = 0.521, 95% CI: 0.348-0.694, P = 0.813) compared with the overall cohort (AUC = 0.644, 95% CI: 0.550-0.738, P = 0.004) and ER + cohort (AUC: 0.559, 95% CI: 0.405-0.713, P = 0.451). And PR status (AUC = 0.760, 95% CI: 0.626-0.894, P = 0.001) had a greater predictive value than ER status (AUC = 0.658, 95% CI: 0.508-0.807, P = 0.048) in group HP. DFS analyses were done on 141 patients. Although ER and PR status did not show significant difference in group HP (P = 0.789 and 0.088, respectively), HP-based therapy contributed to better DFS in the ER - and PR - cohorts (P = 0.035 and 0.015, respectively). CONCLUSIONS Compared with ER status, PR status might be a more valuable factor predicting the efficacy of adding pertuzumab into neoadjuvant therapy for HER2 + /N + BC. PR + patients benefit little from the addition of pertuzumab.
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Affiliation(s)
- Xiaoyu Liu
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhaoyun Liu
- Breast Cancer Center, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Chao Li
- Breast Cancer Center, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Xiang Song
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
- Breast Cancer Center, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Xinzhao Wang
- Breast Cancer Center, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Sumei Li
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Zhiyong Yu
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China.
- Breast Cancer Center, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
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Fan Y, Zhong X, Wang Y, Wang Z, Luo T, Wang Y, Zheng H. A prospective cohort study of clinical characteristics and outcomes in Chinese patients with estrogen receptor-negative/progesterone receptor-positive early breast cancer. Breast Cancer Res Treat 2023:10.1007/s10549-023-06964-6. [PMID: 37199804 DOI: 10.1007/s10549-023-06964-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 04/19/2023] [Indexed: 05/19/2023]
Abstract
PURPOSE This study aimed to examine the clinical characteristics and outcomes of patients with estrogen receptor-negative (ER-)/progesterone receptor-positive (PR+) early breast cancer. We also aimed to investigate the benefits of adjuvant endocrine therapy (ET) in this patient population. METHODS Patients with early breast cancer diagnosed at West China Hospital were divided into the ER-/PR+, ER+, and ER-/PR- groups. The chi-square test was used to analyze differences in clinical and pathological features among the groups. Multivariable Cox and Fine-Gray regression models were used to compare mortality and locoregional recurrence (LRR)/distant recurrence (DR), respectively. We performed a subgroup analysis to determine which ER-/PR+ patients can benefit more from ET. RESULTS From 2008 to 2020, we enrolled 443, 7104, and 2892 patients into the ER-/PR+, ER+, and ER-/PR- groups, respectively. The ER-/PR+ group showed more unfavorable clinical features and aggressive pathological characteristics than the ER+ group. The mortality, LRR, and DR rates were higher in the ER-/PR+ than in the ER+ group. Most clinical features and pathological characteristics were similar between the ER-/PR+ and ER-/PR- group and their outcomes were comparable. In the ER-/PR+ group, patients who received ET showed significantly lower LRR and mortality rates than those who did not; however, no difference was observed in DR. Subgroup analysis suggested that ER-/PR+ patients age ≥ 55 years, and postmenopausal status can benefit from ET. CONCLUSION ER-/PR+ tumors have more aggressive pathological characteristics and more unfavorable clinical features than ER+ tumors. ET can reduce the LRR and mortality rates in ER-/PR+ patients. Postmenopausal and age ≥ 55 years ER-/PR+ patients can benefit from ET.
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Affiliation(s)
- Yu Fan
- Breast Center and Multi-omics Laboratory of Breast Diseases, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Xiaorong Zhong
- Breast Center and Multi-omics Laboratory of Breast Diseases, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Yu Wang
- Breast Center and Multi-omics Laboratory of Breast Diseases, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Zhu Wang
- Breast Center and Multi-omics Laboratory of Breast Diseases, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Ting Luo
- Breast Center and Multi-omics Laboratory of Breast Diseases, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Yanping Wang
- Breast Center and Multi-omics Laboratory of Breast Diseases, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
| | - Hong Zheng
- Breast Center and Multi-omics Laboratory of Breast Diseases, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
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Liu J, Gan M, Lin Z, Deng Q, Deng J, Zeng B, Shi Y, Ming J. Clinical Features and Prognosis Analysis of Hormone Receptor-Positive, HER2-Negative Breast Cancer with Differential Expression Levels of Estrogen and Progesterone Receptors: A 10-Year Retrospective Study. Breast J 2022; 2022:5469163. [PMID: 36531979 DOI: 10.1155/2022/5469163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 10/08/2022] [Accepted: 10/13/2022] [Indexed: 11/30/2022]
Abstract
Background Estrogen and progesterone receptor status can predict breast cancer patient prognosis and treatment sensitivity, but research on low ER and PR levels and expression balance remains limited. Methods From January 2010 to October 2016, 283 ER+/PR+/HER2-breast cancer patients who met the inclusion criteria were enrolled and divided into the H group (ER > 10%, N = 261) and the L group (1% ≤ ER ≤ 10%, N = 22). Groups were further divided into the HH group (ER > 10%/PR > 20%, N = 201), the HL group (ER > 10%/ER 1% ≤ PR ≤ 20% PR, N = 60), the LH group (1% ≤ ER ≤ 10%/PR > 20%, N = 5), and the LL group (1% ≤ ER ≤ 10%/1% ≤ PR ≤ 20%, N = 17). The LH group was excluded due to its small size, leaving the clinical and prognostic characteristics of 2 large groups and 3 subgroups to be analyzed. Results L group patients had significantly more stage N2 axillary lymph nodes than H group patients (31.8% vs. 9.2%, P = 0.007). Age (P = 0.011), menopause status (P = 0.001), and tumor size (P = 0.024) were significantly different in the HL vs. HH and LL groups. Five-year DFS (94.6% vs. 77.0%, P < 0.001) and 5-year OS (97.2% vs. 85.8%, P = 0.001) rates significantly differed between HH and HL. No significant differences in 5-year DFS (77.0% vs. 81.9%, P = 0.564) or 5-year OS (85.8% vs. 87.8%, P = 0.729) rates were observed between HL and LL; the OS rates of HL and LL were similar. Conclusion In the group of ER+/PR+/HER2-patients, there was no significant prognostic difference between ER-low positive and ER-high positive groups, but low PR expression was significantly associated with a worse prognosis. The role of ER and PR balance in breast cancer progression and individualized treatment requires further investigation.
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Ahn JH, Choi SB, Park JM, Kim JY, Park HS, Kim SI, Park BW, Park S. Level of Combined Estrogen and Progesterone Receptor Expression Determines the Eligibility for Adjuvant Endocrine Therapy in Breast Cancer Patients. Cancers (Basel) 2021; 13:5007. [PMID: 34638491 DOI: 10.3390/cancers13195007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 12/28/2022] Open
Abstract
Simple Summary Patients whose breast cancers express low levels of hormone receptor (HR) could be eligible for adjuvant endocrine therapy; however, limited data are available to support this notion. Our retrospective study investigated the characteristics and survival of 6042 breast cancer patients according to four HR groups of combined estrogen and progesterone receptor expression. HR expression levels were prognostic for its recurrence and death of patients with breast cancer. Patients whose tumors expressed high levels of a single HR had the worst survival outcomes, and their risk of death continuously increased even after the 10-year follow-up. Endocrine therapy had a significant benefit for those whose tumors expressed high HR levels and a favorable tendency for patients with tumors expressing low HR levels. We established the value of HR expression level as a prognostic factor and the possible benefit of endocrine therapy for patients whose breast tumors expressed low HR levels. Abstract Hormone receptor (HR)-positive breast cancer has a heterogeneous pattern according to the level of receptor expression. Patients whose breast cancers express low levels of estrogen receptor (ER) or progesterone receptor (PgR) may be eligible for adjuvant endocrine therapy, but limited data are available to support this notion. We aimed to determine whether HR expression level is related to prognosis. Tumors from 6042 patients with breast cancer were retrospectively analyzed for combined HR levels of ER and PgR. Low expression was defined as ER 1–10% and PgR 1–20%. Four HR groups were identified by combining ER and PgR expression levels. Patients whose tumors expressed high levels of a single receptor showed the worst survival outcomes, and their risk continuously increased even after the 10-year follow-up. Endocrine therapy had a significant benefit for patients whose tumors expressed high HR levels and a favorable tendency for patients with tumors expressing low HR levels. We established the possible benefit of endocrine therapy for patients whose breast tumors expressed low HR levels. Thus, HR level was a prognostic factor and might be a determinant of extended therapy, especially for patients with high expression of a single receptor.
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Hwang KT, Suh YJ, Park CH, Lee YJ, Kim JY, Jung JH, Kim S, Min J. Hormone Receptor Subtype in Ductal Carcinoma in Situ: Prognostic and Predictive Roles of the Progesterone Receptor. Oncologist 2021; 26:e1939-e1950. [PMID: 34402131 PMCID: PMC8571738 DOI: 10.1002/onco.13938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 08/05/2021] [Indexed: 11/08/2022] Open
Abstract
Background We investigated the prognostic and predictive roles of the hormone receptor (HRc) subtype in patients with ductal carcinoma in situ (DCIS). We focused on identifying the roles of the progesterone receptor (PR) independent of estrogen receptor (ER) status. Methods Nationwide data of 12,508 female patients diagnosed with DCIS with a mean follow‐up period of 60.7 months were analyzed. HRc subtypes were classified as ER−/PR−, ER−/PR+, ER+/PR−, and ER+/PR+ based on ER and PR statuses. The Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs). Results The ER+/PR+ group showed better prognoses than the ER+/PR− and ER−/PR− groups in the patients who received tamoxifen therapy (p = .001 and p = .031, respectively). HRc subtype was an independent prognostic factor (p = .028). The tamoxifen therapy group showed better survival than the patients who did not receive tamoxifen, but only in the ER+/PR+ subgroup (p = .002). Tamoxifen therapy was an independent prognostic factor (HR, 0.619; 95% CI, 0.423 − 0.907; p = .014). PR status was a favorable prognostic factor in patients with DCIS who received tamoxifen therapy (p < .001), and it remained a prognostic factor independent of ER status (HR, 0.576; 95% CI, 0.349 − 0.951; p = .031). Conclusion The HRc subtype can be used as both a prognostic and predictive marker in patients with newly diagnosed DCIS. Tamoxifen therapy can improve overall survival in the ER+/PR+ subtype. PR status has significant prognostic and predictive roles independent of ER status. Testing for the PR status in addition to the ER status is routinely recommended in patients with DCIS to determine the HRc subtype in clinical settings. Implications for Practice The hormone receptor (HRc) subtype was an independent prognostic factor, and the estrogen receptor (ER)+/progesterone receptor (PR) + subtype showed a better survival in patients with ductal carcinoma in situ (DCIS) who received tamoxifen therapy. PR was an independent prognostic factor independent of ER, and PR was a favorable prognostic factor in patients with DCIS who received tamoxifen therapy. The HRc subtype could be used as both a prognostic and predictive marker in patients with newly diagnosed DCIS. Testing of PR status in addition to ER status is routinely recommended for patients with DCIS to determine the HRc subtype in clinical settings. This study investigated the prognostic and predictive roles of the hormone receptor subtype in patients with newly diagnosed ductal carcinoma in situ, focusing on the prognostic and predictive values of progesterone receptor status independent of estrogen receptor status. The prognostic effect of tamoxifen therapy was also investigated
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Affiliation(s)
- Ki-Tae Hwang
- Department of Surgery, Seoul National University College of Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Young Jin Suh
- Department of Surgery, The Catholic University of Korea St. Vincent's Hospital, Seoul, Republic of Korea
| | - Chan-Heun Park
- Department of Surgery, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Young Joo Lee
- Department of Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Jee Ye Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jin Hyang Jung
- Department of Surgery, Kyungpook National University School of Medicine, Daegu, Republic of Korea
| | - Seeyeong Kim
- Department of Surgery, SaeGyaeRo Hospital, Busan, Republic of Korea
| | - Junwon Min
- Department of Surgery, Dankook University College of Medicine, Cheonan, Republic of Korea
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Lian CL, Zhang HY, Wang J, Lei J, Hua L, Chen YX, Wu SG. Staging for Breast Cancer With Internal Mammary Lymph Nodes Metastasis: Utility of Incorporating Biologic Factors. Front Oncol 2021; 10:584009. [PMID: 33520700 PMCID: PMC7840897 DOI: 10.3389/fonc.2020.584009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/30/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose To validate the 8th edition of the American Joint Committee on Cancer (AJCC) pathological prognostic staging system for breast cancer patients with internal mammary lymph nodes (IMN) metastasis (N3b disease, stage IIIC in 7th AJCC anatomical staging). Methods Breast cancer patients with IMN metastasis diagnosed between 2010 and 2014 were retrieved from the Surveillance, Epidemiology, and End Results program. Chi-squared test, Log-rank test, Kaplan-Meier method, and Cox proportional hazard analysis were applied to statistical analysis. Results We included 678 patients with N3b disease in this study. Overall, 68.4% of patients were downstaged to IIIA and IIIB diseases from the 7th anatomical staging to 8th pathological prognostic staging. The new pathological prognostic staging system had better discriminatory value on prognosis prediction among IMN-metastasized breast cancer patients, with a 5-year breast cancer-specific survival (BCSS) of 92.7, 77.4, and 66.0% in stage IIIA, IIIB, and IIIC diseases, respectively (P<0.0001), and the 5-year overall survival (OS) rates was 85.9, 72.1, and 58.7%, respectively (P<0.0001). The results of the multivariate prognostic analysis showed that the new pathological prognostic staging was the independent prognosis related to BCSS and OS, the 8th AJCC pathological prognostic stages showed worse BCSS and OS with gradually increased hazard ratios. Conclusion The 8th AJCC pathological prognostic staging system offers more refined prognostic stratification to IMN-metastasized breast cancer patients and endorses its use in routine clinical practice for this specific subgroup of breast cancer.
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Affiliation(s)
- Chen-Lu Lian
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Hai-Yan Zhang
- The Sixth People's Hospital of Huizhou, Affiliated Huiyang Hospital of Southern Medical University, Huizhou, China
| | - Jun Wang
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Jian Lei
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Li Hua
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xiamen University, Xiamen, China
| | - Yong-Xiong Chen
- Eye Institute of Xiamen University, Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, School of Medicine, Xiamen University, Xiamen, China
| | - San-Gang Wu
- Department of Radiation Oncology, The First Affiliated Hospital of Xiamen University, Xiamen, China
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Tu Q, Hu C, Zhang H, Peng C, Kong M, Song M, Zhao C, Wang Y, Li J, Zhou C, Wang C, Ma X. Establishment and Validation of Novel Clinical Prognosis Nomograms for Luminal A Breast Cancer Patients with Bone Metastasis. Biomed Res Int 2020; 2020:1972064. [PMID: 33490234 PMCID: PMC7787749 DOI: 10.1155/2020/1972064] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 10/17/2020] [Accepted: 11/28/2020] [Indexed: 02/07/2023]
Abstract
PURPOSE Overall survival (OS) and cancer-specific survival (CSS) of luminal A breast cancer (BC) patients with bone metastasis remain poor and vary dramatically from person to person. Our goal was to build two universally applicable nomograms to accurately predict OS and CSS for luminal A patients with bone metastasis. METHODS The data were collected from the Surveillance, Epidemiology, and End Results (SEER) database for luminal A BC patients with bone metastasis between 2010 and 2015. Univariate and multivariate Cox regression analyses were to assess and identify independent risk factors of OS and CSS. Integrating all significant predictors, nomograms and risk group stratification model was developed. The performance of the nomogram was validated with concordance index (C-index), calibration plots, and decision curve analyses (DCA) for discriminative ability, calibration, and clinical utility, respectively. RESULTS 3171 luminal A BC patients with bone metastasis were included. Through univariate and multivariate Cox regression analyses, 12 variables were identified as both independent OS- and CSS-related factors, including age, race, primary site, histology grade, tumor size, surgery, brain metastasis, liver metastasis, lung metastasis, estrogen receptor status, progesterone receptor status, and insurance. Our nomograms for 1-, 3-, and 5-year survival were based on those significant prognostic factors to develop. The C-indexes of OS- and CSS-nomograms in the training cohort were 0.701 and 0.704, respectively. Similar results were obtained in the validation cohort. The calibration curves and DCA presented satisfactory calibration and clinical utility. CONCLUSION Two nomograms have good discrimination, calibration, and clinical utility, can accurately and effectively predict the prognosis of patients, and may benefit for clinical decision-making. In high-risk patients, more aggressive therapy and closer surveillance should be considered.
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Affiliation(s)
- QiHao Tu
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266071, China
| | - Chuan Hu
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266071, China
| | - Hao Zhang
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266071, China
| | - Chen Peng
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266071, China
| | - Meng Kong
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266071, China
| | - MengXiong Song
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266071, China
| | - Chong Zhao
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266071, China
| | - YuJue Wang
- Medical College of Qingdao University, Qingdao, 266000 Shandong, China
| | - Jianyi Li
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266071, China
| | - ChuanLi Zhou
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266071, China
| | - Chao Wang
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266071, China
| | - XueXiao Ma
- Department of Orthopaedic Surgery, The Affiliated Hospital of Qingdao University, Qingdao 266071, China
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Parks RM, Albanghali M, Syed BM, Green AR, Ellis IO, Cheung KL. Biology of Oestrogen-Receptor Positive Primary Breast Cancer in Older Women with Utilisation of Core Needle Biopsy Samples and Correlation with Clinical Outcome. Cancers (Basel) 2020; 12:E2067. [PMID: 32726924 DOI: 10.3390/cancers12082067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 07/23/2020] [Indexed: 01/16/2023] Open
Abstract
The majority of biological profiling studies use surgical excision (SE) samples, excluding patients receiving nonsurgical and neoadjuvant therapy. We propose using core needle biopsy (CNB) for biological profiling in older women. Over 37 years (1973–2010), 1 758 older (≥70 years) women with operable primary breast cancer attended a dedicated clinic. Of these, 693 had sufficient quality CNB to construct tissue microarray (TMA). The pattern of biomarkers was analysed in oestrogen receptor (ER)-positive cases, using immunohistochemistry and partitional clustering analysis. The biomarkers measured were: progesterone receptor (PgR), Ki67, Epidermal Growth Factor Receptor (EGFR), Human Epidermal Growth Factor Receptor (HER)-2, HER3, HER4, p53, cytokeratins CK5/6 and CK7/8, Mucin (MUC)1, liver kinase B1 (LKB1), Breast Cancer Associated gene (BRCA) 1, B-Cell Lymphoma (BCL)-2, phosphate and tensin homolog (PTEN), vascular endothelial growth factor (VEGF), and Amplified in breast cancer 1 (AIB1). CNB TMA construction was possible in 536 ER-positive cases. Multivariate analysis showed progesterone receptor (PgR) (p = 0.015), Ki67 (p = 0.001), and mucin (MUC)1 (p = 0.033) as independent predictors for breast-cancer-specific survival (BCSS). Cluster analysis revealed three biological clusters, which were consistent with luminal A, luminal B, and low-ER luminal. The low-ER luminal cluster had lower BCSS compared to luminal A and B. The presence of the low-ER luminal cluster unique to older women, identified in a previous study in SE TMAs in the same cohort, is confirmed. This present study is novel in its use of core needle biopsy tissue microarrays to profile the biology of breast cancer in older women.
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Lv M, Mao Y, Song Y, Wang Y, Liu X, Wang X, Nie G, Wang H. Clinical Features and Survival of Single Hormone Receptor-Positive Breast Cancer: A Population-Based Study of 531,605 Patients. Clin Breast Cancer 2020; 20:e589-e599. [PMID: 32565109 DOI: 10.1016/j.clbc.2020.04.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/18/2020] [Accepted: 04/19/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To investigate the prognosis of single hormone receptor-positive (HR+) breast cancer (estrogen receptor [ER] positive and progesterone receptor [PR] negative, and ER-PR+) compared to double HR+ (ER+PR+) and double HR- (ER-PR-) tumors. METHODS We included 531,605 cases of invasive breast cancer between 1990 and 2012 from the US Surveillance, Epidemiology, and End Results (SEER) database for study and classified cases into 4 phenotypes according to expression of ER and PR: ER+PR+, ER+PR-, ER-PR+, and ER-PR-. RESULTS Overall, 66,091 ER+PR- tumors and 9320 ER-PR+ tumors were identified. The clinical characteristics of the ER+PR- group were similar to those of the double HR+ group, while those of the ER-PR+ and double HR- groups were similar. Overall survival of patients with single HR+ tumors was intermediate between that of double HR+ and double HR- tumors. However, we observed no differences in disease-specific survival between ER-PR+ and ER-PR- patients. In multivariate analysis, outcomes were similar. Relative to the double HR+ patient group, risk of death in the ER+PR- group was higher (hazard ratio, 1.422, 95% confidence interval, 1.394-1.452). However, risk of death was comparable between ER-PR+ and ER-PR- patients (hazard ratio, 1.03; 95% confidence interval, 0.98-1.08). Multivariate Cox proportional analysis showed that survival times of patients in the younger age bracket (< 60 years), those positive for human epidermal growth factor receptor 2 (HER2), and patients with tumor stage I-III were longer in the ER-PR+ group. CONCLUSION Disease-specific survival of single HR+ tumor cases was longer than that of double HR- tumors but poorer than double HR+ tumors. However, differences in disease-specific survival were not significant between the ER-PR+ and ER-PR- groups.
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Affiliation(s)
- Meng Lv
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China.
| | - Yan Mao
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China
| | - Yuhua Song
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China
| | - Yongmei Wang
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China
| | - Xiaoyi Liu
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China
| | - Xingang Wang
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China
| | - Gang Nie
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China
| | - Haibo Wang
- Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China.
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Kim EJ, Park HS, Kim JY, Kim SI, Cho YU, Park BW. Assessment of the Prognostic Staging System of American Joint Committee on Cancer 8th Edition for Breast Cancer: Comparisons with the Conventional Anatomic Staging System. J Breast Cancer 2020; 23:59-68. [PMID: 32140270 PMCID: PMC7043951 DOI: 10.4048/jbc.2020.23.e9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 12/03/2019] [Indexed: 12/25/2022] Open
Abstract
Purpose The 8th edition of the American Joint Committee on Cancer (AJCC) staging manual introduced a new prognostic staging system for breast cancer. This study aimed to evaluate the changes in staging distribution and predictive power of the new staging system. Methods Of the 12,275 patients with breast cancer identified from the Severance Breast Cancer Registry who underwent surgery between 1978 and 2016, 12,125 patients met the inclusion criteria. Results In both the 7th and 8th staging systems, stage I patients constituted the largest proportion (38.2% and 48.4%). Migration from the 7th to 8th edition of the AJCC manual resulted in a decrease in stage II population and an increase in stage I and III populations. A total of 1,293 (15.4%) patients were upstaged, and 1,201 (14.3%) were downstaged. Downstaged patients had better recurrence-free and overall survival (p < 0.001). Pathologic complete response after neoadjuvant therapy showed good prognosis as p stage 0, and yp stages I and III showed poorer outcomes than the same p stage (p < 0.001). Conclusions Staging migrations are common in early breast cancer under the prognostic staging system. The prognostic staging system of the 8th edition of the AJCC manual discriminates survival outcomes better than the anatomical staging system of the 7th edition of the AJCC manual.
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Affiliation(s)
- Eun Jin Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Hyung Seok Park
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Jee Ye Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Il Kim
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Young-Up Cho
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Byeong-Woo Park
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
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Boland MR, Ryan ÉJ, Dunne E, Aherne TM, Bhatt NR, Lowery AJ. Meta-analysis of the impact of progesterone receptor status on oncological outcomes in oestrogen receptor-positive breast cancer. Br J Surg 2019; 107:33-43. [PMID: 31755998 DOI: 10.1002/bjs.11347] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/21/2019] [Accepted: 07/30/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Assessment of the oestrogen receptor (ER) provides important prognostic information in breast cancer. The impact of progesterone receptor (PgR) status is less clear. Standardization of immunohistochemical analysis of these receptors has reduced interstudy heterogeneity. The aim of this meta-analysis was to evaluate the impact of PgR negativity on outcomes in ER-positive (ER+) breast cancer. METHODS This study was performed according to PRISMA and MOOSE guidelines. PubMed, Embase and the Cochrane Library were searched systematically to identify studies comparing disease-free survival as the primary outcome and overall survival as secondary outcome between PgR-positive (PgR+) and PgR-negative (PgR-) status in ER+ breast cancer. A meta-analysis of time-to-effect measures from included studies was undertaken. RESULTS Eight studies including 13 667 patients, 11 838 in the ER+PgR+ group and 1829 in the ER+PgR- group, met the inclusion criteria. Treatment characteristics did not differ significantly between the two groups. Patients in the ER+PgR- group had a higher risk of disease recurrence than those who had ER+PgR+ disease (hazard ratio (HR) 1·57, 95 per cent c.i. 1·38 to 1·79; P < 0·001). This hazard was increased in patients with human epidermal growth factor receptor 2-negative tumours (HR 1·62, 1·37 to 1·93; P < 0·001). A similar result was observed for overall survival (HR 1·69, 1·33 to 2·14; P < 0·001). CONCLUSION PgR negativity is associated with significant reductions in disease-free and overall survival in ER+ breast cancer. Treatment and surveillance strategies in these patients should be tailored accordingly.
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Affiliation(s)
- M R Boland
- Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - É J Ryan
- Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - E Dunne
- Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - T M Aherne
- Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - N R Bhatt
- Department of Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - A J Lowery
- Discipline of Surgery, Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland
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Hwang KT, Kim J, Jung J, Kim BH, Park JH, Jeon SY, Hwang KR, Roh EY, Park JH, Kim SJ. Long-term prognostic effect of hormone receptor subtype on breast cancer. Breast Cancer Res Treat 2019; 179:139-151. [PMID: 31595365 DOI: 10.1007/s10549-019-05456-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 09/24/2019] [Indexed: 01/04/2023]
Abstract
PURPOSE To determine the long-term prognostic role of hormone receptor subtype in breast cancer using surveillance, epidemiology, and end results (SEER) database. METHODS Data of 810,587 female operable invasive breast cancer patients from SEER database with a mean follow-up period of 94.2 months (range, 0-311 months) were analyzed. Hormone receptor subtype was classified into four groups based on estrogen receptor (ER) and progesterone receptor (PR) statuses: ER(+)/PR(+), ER(+)/PR(-), ER(-)/PR(+), and ER(-)/PR(-). RESULTS Numbers of subjects with ER(+)/PR(+), ER(+)/PR(-), ER(-)/PR(+), ER(-)/PR(-), and unknown were 496,279 (61.2%), 86,858 (10.7%), 11,545 (1.4%), 135,441 (16.7%), and 80,464 (9.9%), respectively. The ER(+)/PR(+) subtype showed the best breast-cancer-specific survival, followed by ER(+)/PR(-), ER(-)/PR(+), and ER(-)/PR(-) subtypes in the respective order (all p < 0.001). Survival difference among hormone receptor subtypes was maintained in subgroup analysis according to anatomic stage, race, age group, and year of diagnosis. Hormone receptor subtype was a significant independent prognostic factor in multivariable analyses (p < 0.001). Hazard ratios of ER(+)/PR(-), ER(-)/PR(+), and ER(-)/PR(-) for breast-cancer-specific mortality risk were 1.419 (95% confidence interval [CI] 1.383-1.456), 1.630 (95% CI 1.537-1.729), and 1.811 (95% CI 1.773-1.848), respectively, with ER(+)/PR(+) as reference. CONCLUSION Hormone receptor subtype is a significant independent prognostic factor in female operable invasive breast cancer patients with long-term effect. The ER(+)/PR(+) subtype shows the most favorable prognosis, followed by ER(+)/PR(-), ER(-)/PR(+), and ER(-)/PR(-) subtypes in the respective order. Prognostic impacts of hormone receptor subtypes are also maintained in subgroup analysis according to anatomic stage, race, age, and year of diagnosis.
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Affiliation(s)
- Ki-Tae Hwang
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 39, Boramae-Gil, Dongjak-gu, Seoul, 156-707, Republic of Korea.
| | - Jongjin Kim
- Department of Surgery, Seoul Metropolitan Government Seoul National University Boramae Medical Center, 39, Boramae-Gil, Dongjak-gu, Seoul, 156-707, Republic of Korea
| | - Jiwoong Jung
- Department of Surgery, Seoul Medical Center, Seoul, Republic of Korea
| | - Byoung Hyuck Kim
- Department of Radiation Oncology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jeong Hwan Park
- Department of Pathology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Sook Young Jeon
- Department of Surgery, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Kyu Ri Hwang
- Department of Obstetrics and Gynecology, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Eun Youn Roh
- Department of Laboratory Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jin Hyun Park
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Su-Jin Kim
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
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Wu N, Fu F, Chen L, Lin Y, Yang P, Wang C. Single hormone receptor-positive breast cancer patients experienced poor survival outcomes: a systematic review and meta-analysis. Clin Transl Oncol 2019; 22:474-485. [PMID: 31222450 DOI: 10.1007/s12094-019-02149-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/28/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND The prognostic and clinical significance of single hormone receptor expression in breast cancer has not been clearly established. The goal of this study was to conduct a meta-analysis to compare the clinical outcomes of patients with ER+PR- tumours and ER-PR+ tumours to those of patients with ER+PR+ tumours. METHODS A systematic review of the literature was conducted to identify studies that compared the clinical outcome of patients with ER+PR- tumours or ER-PR+ tumours with those of patients with ER+PR+ tumours. A total of 18 studies met the inclusion criteria and included 217,485 women. Standard methods for meta-analysis were used, including fixed-effect models. RESULTS Patients with ER+PR- tumours or ER-PR+ tumours had significantly worse DFS (HR 1.60, 95% CI 1.44-1.77 and HR 2.27, 95% CI 1.67-3.09), BCSS (HR 1.43, 95% CI 1.33-1.53 and HR 1.82, 95% CI 1.68-1.98) and OS (HR 1.38, 95% CI 1.28-1.47 and HR 1.48, 95% CI 1.17-1.89) than those of patients with ER+PR+ tumours. In subgroup analyses, patients who had ER+PR- tumours experienced a higher risk of recurrence than patients with ER+PR+ tumours in the HER2- (HR 1.57, 95% CI 1.32-1.87), LN - (HR 2.07, 95% CI 1.44-2.86) and endocrine therapy (HR 1.65, 95% CI 1.45-1.89) subgroup. Patients who had HER2- and ER-PR+ tumours had an increased risk of recurrence compared with patients who had HER2- and ER+PR+ tumours (HR 3.10, 95% CI 1.92-5.10). CONCLUSIONS Among patients with hormone receptor-positive breast cancer, patients with either ER+PR- tumours or ER-PR+ tumours have a higher risk of recurrence and a shorter survival time than those with ER+PR+ tumours. Patients with both types of breast cancer need additional or better treatments.
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Affiliation(s)
- N Wu
- Department of General Surgery, Affiliated Union Hospital of Fujian Medical University, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China
| | - F Fu
- Department of General Surgery, Affiliated Union Hospital of Fujian Medical University, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China.
| | - L Chen
- Department of General Surgery, Affiliated Union Hospital of Fujian Medical University, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China
| | - Y Lin
- Department of General Surgery, Affiliated Union Hospital of Fujian Medical University, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China
| | - P Yang
- Department of General Surgery, Affiliated Union Hospital of Fujian Medical University, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China
| | - C Wang
- Department of General Surgery, Affiliated Union Hospital of Fujian Medical University, No. 29, Xin Quan Road, Gulou District, Fuzhou, 350001, Fujian, China.
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Qiu J, Du Z, Wang Y, Zhou Y, Zhang J, Liu P, Lv Q. Adjuvant Chemotherapy Guidance in Young Breast Cancer Patients With Luminal Subtypes and Stage pT1N0. J Surg Res 2019; 240:165-74. [PMID: 30951993 DOI: 10.1016/j.jss.2019.01.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Revised: 12/28/2018] [Accepted: 01/25/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND This study evaluated whether young breast cancer patients (≤ 40 y of age) with luminal subtypes and stage pT1N0 can benefit from chemotherapy (CHT). MATERIALS AND METHODS This study included 688 patients aged ≤ 40 y with luminal subtypes and stage pT1N0 breast cancer. The overall survival and disease-free survival (DFS) rates in the whole cohort and subgroups were compared between patients receiving CHT followed by endocrinotherapy (ET) (CHT→ET group) and those receiving only ET (ET-alone group). RESULTS Univariate analysis identified that the tumors in the CHT→ET group were more aggressive than those in the ET-alone group. However, the overall survival and DFS rates did not differ significantly between the CHT→ET and ET-alone groups (P = 0.416 and 0.21, respectively), implying that a subgroup of patients could benefit from CHT. Subgroup analysis of DFS rates revealed that patients with human epidermal growth factor receptor 2 overexpression (P = 0.042), histological classification grade 3 (P = 0.030), progesterone receptor ≤ 20% (P = 0.033), and clinical stage T1c (P = 0.038) could benefit from CHT. Further analysis showed that these four risk factors combined predicted whether the patient could benefit from CHT. CONCLUSIONS Young patients with hormone receptor-positive and stage pT1N0 breast cancer may benefit from CHT only if they exhibit at least two of the following risk factors: progesterone receptor ≤ 20%, human epidermal growth factor receptor 2 overexpression, histological grading 3, or clinical stage T1c.
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Chen X, Fan Y, Xu B. Distinct Characteristics and Metastatic Behaviors of Late Recurrence in Patients With Hormone Receptor-positive/Human Epidermal Growth Factor Receptor 2-negative Breast Cancer: A Single Institute Experience of More Than 10 Years. Clin Breast Cancer 2018; 18:e1353-60. [DOI: 10.1016/j.clbc.2018.07.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/28/2018] [Accepted: 07/13/2018] [Indexed: 01/04/2023]
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Kunc M, Biernat W, Senkus-konefka E. Estrogen receptor-negative progesterone receptor-positive breast cancer – “Nobody's land“ or just an artifact? Cancer Treat Rev 2018; 67:78-87. [DOI: 10.1016/j.ctrv.2018.05.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 05/08/2018] [Accepted: 05/09/2018] [Indexed: 12/27/2022]
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Wang M, Chen H, Wu K, Ding A, Zhang M, Zhang P. Evaluation of the prognostic stage in the 8th edition of the American Joint Committee on Cancer in locally advanced breast cancer: An analysis based on SEER 18 database. Breast 2018; 37:56-63. [PMID: 29100045 DOI: 10.1016/j.breast.2017.10.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/23/2017] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND The new "prognostic stage" in the 8th edition of the American Joint Committee on Cancer (AJCC) incorporated important biologic factors such as estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER2), histologic grade and TNM stage into one system. The objective of this study was to evaluate the "prognostic stage" in locally advanced breast cancer (LABC) based on the Surveillance, Epidemiology, and End Results (SEER) 18 database. METHODS 10053 LABCs diagnosed between 2010 and 2013 were enrolled. TNM stage was based on AJCC 7th edition. Comparisons of biologic factor proportions among stage changes were performed using Pearson's chi-square test. Breast cancer-specific survival (BCSS) and overall survival (OS) were estimated using the Kaplan-Meier method and log rank testing with pairwise comparisons between different stages was conducted. Cox models were fitted to assess the independent prognostic factors. RESULTS The prognostic stage grouped LABC into six stages: IB-IIIC among which IB-IIIA had a relatively better survival. It reassigned 74% LABCs to a different tumor stage. 60.4% cases in grade III and 68.3% cases with triple negative breast cancer were upstaged while 57.1% cases with ER/PR dual positivity were down staged. It was an independent prognostic factor of LABC. There were statistically significant survival differences among stage IB-IIIA, IIIB and IIIC. Among each TNM stage, there were statistically significant survival differences among stage changes. CONCLUSIONS The prognostic stage provided accurate prognostic information for LABC compared with anatomic TNM stage. It will lead to accuracy in prognosis prediction and optimal treatment selection, and therefore, better outcomes.
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Caldarella A, Barchielli A. Prognostic role of progesterone receptor expression in a population-based analysis. J Cancer Res Clin Oncol 2017; 143:2505-2509. [PMID: 28889189 DOI: 10.1007/s00432-017-2514-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 08/31/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE The role of progesterone (PR) expression in the management of breast cancer is controversial. The aim of this study is to evaluate the characteristics and prognosis of progesterone status among breast cancers patients in a population-based analysis. MATERIALS AND METHODS Through the Tuscan Cancer Registry data on all the invasive breast cancer cases diagnosed during the period 2004-2005 in the provinces of Florence and Prato, central Italy, were retrieved. Histological reports were re-examined to obtain information on the percentage of positive tumor cells for estrogen (ER), progesterone (PR) receptors, Ki67 marker and human epidermal growth factor 2 (HER2). Information on age, stage, differentiation grade were also obtained. RESULTS Out of 1487 patients, 28% had PR- breast cancer. These patients were older (p 0.006) than PR+ cancer patients, with more frequently high Ki67 (p < 0.0001), HER2 + (p < 0.0001), ER- (p < 0.0001) tumoral expression. The ER+/PR+ subtype was the most represented (n.1053), while ER-/PR+ was the most rare (n.23); 210 cases (14.1%) ER+ PR- and 201 (13.5%) ER-/PR- cases were found. Analysis of survival by the Cox proportional hazards model showed an independent prognostic value of PR expression (p < 0.0001), also when estrogen, Ki67, HER2 status and age were included. The 5-year cancer-specific survival was 82.1, 86.5, 100, 92% for ER-/PR-, ER+/PR-, ER-/PR+, ER+/PR+ subtype, respectively. CONCLUSIONS Our study revealed significant differences in clinicopathological characteristics among breast cancer according to PR expression and confirmed its prognostic independent role, suggesting a role of PR in the improvement of breast cancer prognostic characterization.
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Affiliation(s)
- Adele Caldarella
- Clinical Epidemiology, Institute for Study and Cancer Prevention, via Cosimo il Vecchio 2, 50141, Florence, Italy.
| | - Alessandro Barchielli
- Clinical Epidemiology, Institute for Study and Cancer Prevention, via Cosimo il Vecchio 2, 50141, Florence, Italy
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Agarwal K, Hariprasad G, Rani K, Sharma U, Mathur SR, Seenu V, Parshad R, Jagannathan NR. Is there an association between enhanced choline and β-catenin pathway in breast cancer? A pilot study by MR Spectroscopy and ELISA. Sci Rep 2017; 7:2221. [PMID: 28533512 DOI: 10.1038/s41598-017-01459-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 03/30/2017] [Indexed: 12/19/2022] Open
Abstract
Total choline (tCho) was documented as a biomarker for breast cancer diagnosis by in vivo MRS. To understand the molecular mechanisms behind elevated tCho in breast cancer, an association of tCho with β-catenin and cyclin D1 was evaluated. Hundred fractions from 20 malignant, 10 benign and 20 non-involved breast tissues were isolated. Cytosolic and nuclear expressions of β-catenin and cyclin D1 were estimated using ELISA. Higher tCho was seen in malignant compared to benign tissues. Malignant tissues showed higher cytosolic and nuclear β-catenin expressions than benign and non-involved tissues. Within malignant tissues, β-catenin and cyclin D1 expressions were higher in the nucleus than cytosol. Cyclin D1 expression was higher in the cytosolic fractions of benign and non-involved than malignant tissues. Furthermore, in malignant tissues, tCho showed a positive correlation with the cytosolic and nuclear expression of β-catenin and cyclin D1 and also a correlation between nuclear expressions of both these proteins was seen. Higher cytosolic β-catenin expression was seen in progesterone receptor negative than positive patients. Results provide an evidence of correlation between non-invasive biomarker, tCho and the Wnt/β-catenin pathway. The findings explain the molecular mechanism of tCho elevation which may facilitate exploration of additional therapeutic targets for breast cancer.
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Kim MK, Park HS, Kim JY, Kim S, Nam S, Park S, Kim SI. The clinical implication of the number of lymph nodes harvested during sentinel lymph node biopsy and its effects on survival outcome in patients with node-negative breast cancer. Am J Surg 2016; 214:726-732. [PMID: 27998550 DOI: 10.1016/j.amjsurg.2016.10.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 09/26/2016] [Accepted: 10/24/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND The optimal number of sentinel lymph nodes (SLN) that need to be harvested to achieve favorable survival outcome during a SLN biopsy (SLNB) has not yet been established. METHODS Six hundred and thirteen patients with clinically node-negative breast cancer who underwent SLNB were reviewed. Survival outcomes according to the number of total harvested lymph nodes (THLNs), defined as the sum of enumerated SLNs and non-SLNs were analyzed. RESULTS Patients with only 1 THLN showed lower recurrence-free survival (RFS) as compared to those with ≥2 THLNs (p = 0.049). In multivariate analysis, only 1 THLN was associated with poor RFS (HR = 2.711; p = 0.029). CONCLUSIONS Removing at least 2 lymph nodes during SLNB may be acceptable. Harvesting only 1 lymph node should be undertaken cautiously because of false negative results and increasing the subsequent recurrence rate.
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Affiliation(s)
- Mi Kyoung Kim
- Department of Surgery, Yonsei University College of Medicine, Republic of Korea
| | - Hyung Seok Park
- Department of Surgery, Yonsei University College of Medicine, Republic of Korea.
| | - Jee Ye Kim
- Department of Surgery, Yonsei University College of Medicine, Republic of Korea
| | - Sanghwa Kim
- Department of Surgery, Yonsei University College of Medicine, Republic of Korea
| | - Sanggeun Nam
- Department of Surgery, Yonsei University College of Medicine, Republic of Korea
| | - Seho Park
- Department of Surgery, Yonsei University College of Medicine, Republic of Korea
| | - Seung Il Kim
- Department of Surgery, Yonsei University College of Medicine, Republic of Korea
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Park C, Park K, Kim J, Sin Y, Park I, Cho H, Yang K, Bae BN, Kim KW, Ahn S, Gwak G. Prognostic values of negative estrogen or progesterone receptor expression in patients with luminal B HER2-negative breast cancer. World J Surg Oncol 2016; 14:244. [PMID: 27619909 PMCID: PMC5020449 DOI: 10.1186/s12957-016-0999-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 08/31/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The luminal subtype of breast cancer is sensitive to anti-estrogen therapy and shows a better prognosis than that of human epidermal growth factor receptor2 (HER2)-enriched or triple-negative breast cancer. However, the luminal type of breast cancer is heterogeneous and can have aggressive clinical features. We investigated the clinical implications of single hormone receptor negativity in a luminal B HER2-negative group. METHODS We collected luminal B HER2-negative breast cancer data that were estrogen receptor (ER) and/or progesterone receptor (PR) positive, Ki 67 high (>14 %), and HER2 negative and divided them into the ER- and PR-positive group and the ER- or PR-negative group. We analyzed the clinical and pathological data and survival according to ER or PR loss. RESULTS There were no statistical differences in TNM stage, breast and axillary operative methods, or number of tumors between the ER- and PR-positive group and ER- or PR-negative group. However, the ER- or PR-negative group was associated with older age (≥45 years), higher histological grade, lower Bcl-2 expression, and far higher Ki 67 (>50 %). Disease-free survival (DFS) and overall survival (OS) were shorter in the ER- or PR-negative group than that in the ER- and PR-positive group (p = 0.0038, p = 0.0071). CONCLUSIONS ER- or PR-negative subgroup showed worse prognosis than ER- and PR-positive subgroup in the luminal B HER2-negative group. We could consider the negativity of ER or PR as prognostic marker in luminal B HER2-negative subtype of breast cancer.
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Affiliation(s)
- Chansub Park
- Department of Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, 1342 Dongil-ro, Nowon-gu, Seoul, 139-707, Korea
| | - Kyeongmee Park
- Department of Pathology, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Jiyoung Kim
- Department of Diagnostic Radiology, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Youngjoo Sin
- Department of Radiologic Oncologist, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Inseok Park
- Department of Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, 1342 Dongil-ro, Nowon-gu, Seoul, 139-707, Korea
| | - Hyunjin Cho
- Department of Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, 1342 Dongil-ro, Nowon-gu, Seoul, 139-707, Korea
| | - Keunho Yang
- Department of Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, 1342 Dongil-ro, Nowon-gu, Seoul, 139-707, Korea
| | - Byung Noe Bae
- Department of Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, 1342 Dongil-ro, Nowon-gu, Seoul, 139-707, Korea
| | - Ki Whan Kim
- Department of Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, 1342 Dongil-ro, Nowon-gu, Seoul, 139-707, Korea
| | - Sookyung Ahn
- Department of Surgery, Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea
| | - Geumhee Gwak
- Department of Surgery, Sanggye Paik Hospital, College of Medicine, Inje University, 1342 Dongil-ro, Nowon-gu, Seoul, 139-707, Korea.
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Sun JY, Wu SG, Li FY, Lin HX, He ZY. Progesterone receptor loss identifies hormone receptor-positive and HER2-negative breast cancer subgroups at higher risk of relapse: a retrospective cohort study. Onco Targets Ther 2016; 9:1707-13. [PMID: 27051305 PMCID: PMC4807933 DOI: 10.2147/ott.s98666] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background To assess the prognostic value of progesterone receptor (PR) expression in patients with hormone receptor-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer subgroups. Methods A retrospective review of breast cancer patients who underwent mastectomy or breast-conserving surgery between January 1998 and December 2007 was performed. The prognostic impact of PR status on disease-free survival (DFS) was analyzed. Results Of the 1,301 patients included in this study, the median follow-up time was 64 months, and the median age was 46 years. There were 18.4% of patients (n=219) with PR negative (PR−) cancer. Women with PR–breast cancer were more likely to be postmenopausal (P<0.001) and have pN3 stage (P=0.031) and Stage III (P=0.049) cancer. Cox regression univariate and multivariate analysis showed that PR status was a significant prognostic factor for DFS. Patients with PR− status had poorer DFS (hazard ratio =1.626, 95% confidence interval =1.060–2.497, P=0.026). The 5-year DFS for patients with PR− and PR+ breast cancer was 79.4% and 86.2%, respectively, and the 8-year DFS for patients with PR− and PR+ breast cancer was 69.6% and 78.1%, respectively (P=0.012). A significant difference in DFS was observed between PR− and PR+ disease in patients with node-negative cancer, but was not for patients with lymph node metastasis (P=0.242). In premenopausal patients, DFS varied significantly by PR status (P=0.049). A marginally significant difference in DFS between the PR− and PR+ disease was seen in postmenopausal patients (log rank P=0.065). Conclusion Lack of PR expression is associated with worse survival in patients with hormone receptor-positive and HER2-negative breast cancer subgroups.
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Affiliation(s)
- Jia-Yuan Sun
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China
| | - San-Gang Wu
- Department of Radiation Oncology, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, People's Republic of China
| | - Feng-Yan Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China
| | - Huan-Xin Lin
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China
| | - Zhen-Yu He
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People's Republic of China
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Liu J, Chen K, Mao K, Su F, Liu Q, Jacobs LK. The prognostic value of age for invasive lobular breast cancer depending on estrogen receptor and progesterone receptor-defined subtypes: A NCDB analysis. Oncotarget 2016; 7:6063-73. [PMID: 26515602 PMCID: PMC4868740 DOI: 10.18632/oncotarget.5844] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 10/15/2015] [Indexed: 11/25/2022] Open
Abstract
PURPOSE We aimed to assess the effect of age on survival according to estrogen receptor (ER) and progesterone receptor (PR)-defined lobular breast cancer subtype in a wide age range. METHODS 43,230 invasive lobular breast cancer women without comorbidities diagnosed between 2004 and 2011 in the National Cancer Database (NCDB) were analyzed. The effects of age on overall survival (OS) among different age groups were evaluated by log-rank test and Cox proportional model. RESULTS Multivariate analysis showed that patients diagnosed at both young (< 35 years) and old (≥ 70 years) ages had worse prognosis compared with those in the middle ages. We further analyzed the interaction between age and molecular subtype for predicting OS: in ER+PR+ subtype, the HR of OS declined with age from 1.55 (95% CI, 1.08-2.22; P = 0.019) in the group younger than 35 years to 1.38 (1.02-1.86; P = 0.036) in the 35-39 group, but increased with age to 10.1 (8.49-11.94; P < 0.001) in the group older than 79. While in ER+PR- and ER-PR- subtypes, the HRs showed no statistical differences among women diagnosed before 60 (P > 0.1); and in ER-PR+ subgroup, the HRs were similar in patients younger than 70 (P > 0.1); thus, the plots of HRs in these three subtypes remained steady until the age of 60 or 70. CONCLUSIONS Our findings identified that the effect of age on OS in lobular breast cancer varied with ER/PR-defined subtypes. Personalized treatment strategies should be developed to improve outcomes of breast cancer patients with different ages and ER/PR statuses.
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Affiliation(s)
- Jieqiong Liu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kai Chen
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kai Mao
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of General Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Fengxi Su
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiang Liu
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Breast Surgery, Breast Tumor Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lisa K. Jacobs
- Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Schroth W, Winter S, Büttner F, Goletz S, Faißt S, Brinkmann F, Saladores P, Heidemann E, Ott G, Gerteis A, Alscher MD, Dippon J, Schwab M, Brauch H, Fritz P. Clinical outcome and global gene expression data support the existence of the estrogen receptor-negative/progesterone receptor-positive invasive breast cancer phenotype. Breast Cancer Res Treat 2015; 155:85-97. [DOI: 10.1007/s10549-015-3651-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 11/26/2015] [Indexed: 01/08/2023]
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25
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Fan Y, Ding X, Xu B, Ma F, Yuan P, Wang J, Zhang P, Li Q, Luo Y. Prognostic Significance of Single Progesterone Receptor Positivity: A Comparison Study of Estrogen Receptor Negative/Progesterone Receptor Positive/Her2 Negative Primary Breast Cancer With Triple Negative Breast Cancer. Medicine (Baltimore) 2015; 94:e2066. [PMID: 26579819 PMCID: PMC4652828 DOI: 10.1097/md.0000000000002066] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Single progesterone receptor positive (PgR+), especially in form of ER-/PgR+/HER2-, is a nonnegligible phenomenon. Little is known about the characteristics and the role of single PgR positive in this phenotype. Therefore, we explore the significance of single PgR positivity by comparing ER-/PgR+/HER2- breast cancers with triple negative breast cancers (TNBCs).Three thousand nine hundred sixty-six cases of primary invasive breast carcinoma operated consecutively from January 2005 to May 2008 in Cancer Hospital, Chinese Academy of Medical Sciences were examined. Two hundred forty (6%) cases were identified as ER-/PgR+/HER2- breast cancers and 348 (8.8%) cases as TNBCs. Clinicopathological characteristics and survivals were analyzed respectively and then compared between 2 subtypes.Compared with patients with TNBCs, ER-/PgR+/HER2- tumor tended to have lower tumor grade (Grade 3: 45.7% vs. 37.5%, P = 0.051) and smaller tumor size (P = 0.036). However, no differences were found between ER-/PgR+/HER2- and TNBC patients in relapse-free survival (RFS) and OS. The 5-year RFS rates were 80.7% and 77.4%, respectively (P = 0.330) and the 5-year OS rates were 88.0% and 85.2%, respectively (P = 0.290). ER-/PgR+/HER2- patients receiving adjuvant endocrine treatment had better RFS (P = 0.016) and overall survival (OS) (P < 0.0001) than patients receiving no endocrine therapy.This exclusive analysis of patients with ER-/PgR+/HER2- breast cancers showed that this subtype exhibited an aggressive behavior as TNBC, suggesting that it should also be regarded as biologically distinctive group and single PgR positive itself is not a good prognostic factor. However, adjuvant endocrine therapy could still benefit this group of patients. Further investigations should be done to elucidate the underlying mechanism.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/diagnosis
- Breast Neoplasms/metabolism
- Breast Neoplasms/mortality
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/diagnosis
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/therapy
- Female
- Follow-Up Studies
- Humans
- Middle Aged
- Neoplasm Grading
- Neoplasm Recurrence, Local/etiology
- Prognosis
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Retrospective Studies
- Survival Analysis
- Triple Negative Breast Neoplasms/diagnosis
- Triple Negative Breast Neoplasms/metabolism
- Triple Negative Breast Neoplasms/mortality
- Triple Negative Breast Neoplasms/therapy
- Tumor Burden
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Affiliation(s)
- Ying Fan
- From the Department of Medical Oncology, Cancer Hospital& Institute, Chinese Academy of Medical Sciences and Peking Union Medical College (YF, BX, FM, PY, JW, PZ, QL, YL); and Department of Oncology, Beijing DiTan Hospital, Capital Medical University, Beijing, P.R. China (XD)
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Li AQ, Zhou SL, Li M, Xu Y, Shui RH, Yu BH, Yang WT. Clinicopathologic Characteristics of Oestrogen Receptor-Positive/Progesterone Receptor-Negative/Her2-Negative Breast Cancer According to a Novel Definition of Negative Progesterone Receptor Status: A Large Population-Based Study from China. PLoS One 2015; 10:e0125067. [PMID: 25938238 DOI: 10.1371/journal.pone.0125067] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 03/19/2015] [Indexed: 12/27/2022] Open
Abstract
Purpose A lack of progesterone receptor (PgR) expression in oestrogen receptor-positive (ER+) tumours is associated with worse survival. PgR status is usually defined as positive or negative using 1% positive nuclei as a cut-off point. In this study, we aimed to assess the clinicopathologic characteristics of ER+/PgR-/HER2- tumours by comparing them with ER+/PgR+/HER2- tumours using a PgR cut-off point of 20% as a divisive criterion. Methods We analysed 1,522 patients with primary breast cancer who had undergone surgery at the Cancer Center of Fudan University between 2012 and 2014. Age, grade, tumour size, lymph node status and lymphovascular invasion were assessed. Multinomial logistic regression, linear regression and chi-square test models were applied to assess associations between ER, PR and clinical features. Results ER+/PgR-/HER2- tumours showed poorer clinicopathologic characteristics relative to ER+/PgR+/HER2- tumours using a PgR threshold of 20% instead of 1%. The clinicopathologic characteristics did not differ between tumours with purely negative PgR expression and tumours with a PgR percentage ranging from 1% to 19%. The prognostic significance of PR expression appeared more pronounced in patients under a high Ki-67 status than those under a low Ki-67 status. Conclusions Based on these findings, we propose the use of a novel threshold of 20% to define PgR status. Nevertheless, the impact of this new criterion on patient management and clinical treatment requires additional study.
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Qinghong Q, Fangfang G, Wei J, Qixing T, Qinguo M, Changyuan W. Effect of neoadjuvant chemotherapy on expressions of estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2, and Ki-67 in breast cancer: . Chin Med J (Engl) 2014; 127:3272-7. [DOI: 10.1097/00029330-201409200-00015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Mihály Z, Győrffy B. Improving Pathological Assessment of Breast Cancer by Employing Array-Based Transcriptome Analysis. Microarrays (Basel) 2013; 2:228-42. [PMID: 27605190 DOI: 10.3390/microarrays2030228] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Revised: 08/17/2013] [Accepted: 08/22/2013] [Indexed: 01/13/2023]
Abstract
Breast cancer research has paved the way of personalized oncology with the introduction of hormonal therapy and the measurement of estrogen receptor as the first widely accepted clinical biomarker. The expression of another receptor—HER2/ERBB2/neu—was initially a sign of worse prognosis, but targeted therapy has granted improved outcome for these patients so that today HER2 positive patients have better prognosis than HER2 negative patients. Later, the introduction of multigene assays provided the pathologists with an unbiased assessment of the tumors’ molecular fingerprint. The recent FDA approval of complete microarray pipelines has opened new possibilities for the objective classification of breast cancer samples. Here we review the applications of microarrays for determining ER and HER2 status, molecular subtypes as well as predicting prognosis and grade for breast cancer patients. An open question remains the role of single genes within such signatures. Openly available microarray datasets enable the execution of an independent cross-validation of new marker and signature candidates. In summary, we review the current state regarding clinical applications of microarrays in breast cancer molecular pathology.
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