Breast cancer subtype approximated by estrogen receptor, progesterone receptor, and HER-2 is associated with local and distant recurrence after breast-conserving therapy
Breast cancer subtype approximated by estrogen receptor, progesterone receptor, and HER-2 is associated with local and distant recurrence after breast-conserving therapy
复制标题
DOI：
10.1200/jco.2007.14.4287
复制
发表时间：
2008-05-10
影响因子：
45.3
通讯作者：
Harris, Jay R.
中科院分区：
文献类型：
--
作者：
Nguyen, Paul L.;Taghian, Alphonse G.;Harris, Jay R.
PurposeTo确定乳腺癌亚型是否与乳腺癌保乳治疗（BCT）后的结果，包括乳房肿瘤切除术和放射治疗。患者和MethodsWe研究了793例连续浸润性乳腺癌患者接受BCT从1998年7月至2001年12月。其中，97%的患者切缘病理阴性，90%的患者接受了辅助全身治疗。无患者接受曲妥珠单抗辅助治疗。受体状态用于近似亚型：雌激素受体（ER）或孕激素受体（PR）阳性和人表皮生长因子受体2阴性=管腔A; ER +或PR +和HER-2 + =管腔B; ER-和PR-和HER-2 + = HER-2; ER-和PR-和HER-2- =基础。竞争风险的方法被用来分析时间局部复发和远处metastases.ResultsMedian随访70个月。局部复发的总体5年累积发生率为1.8%（95% CI，1.0 - 3.1）;管腔A组为0.8%（0.3，2.2），管腔B组为1.5%（0.2，10），HER-2组为8.4%（2.2，30），基底组为7.1%（3.0，16）。在以管腔A为基线的多变量分析（MVA）中，HER-2（调整后的风险比[AHR] = 9.2; 95% CI，1.6 - 51; P = 0.012）和基础（AHR = 7.1; 95% CI，1.6 - 31; P = 0.009）亚型与局部复发增加相关。在MVA上，管腔B（AHR = 2.9; 95%CI，1.3至6.5; P = 0.007）和基础（AHR = 2.3; 95%CI，1.1至5.2; P = 0.035）与增加的远处transferation.ConclusionOverall，5年局部复发率后BCT是低的，但不同的亚型近似使用ER，PR，HER-2状态。局部复发是特别低的管腔A亚型，但在5年的所有亚型低于10%。虽然需要进一步随访，但这些结果可能有助于为患者提供关于BCT后预期结局的咨询。
PurposeTo determine whether breast cancer subtype is associated with outcome after breast-conserving therapy (BCT) consisting of lumpectomy and radiation therapy.Patients and MethodsWe studied 793 consecutive patients with invasive breast cancer who received BCT from July 1998 to December 2001. Among them, 97% had pathologically negative margins of resection, and 90% received adjuvant systemic therapy. No patient received adjuvant trastuzumab. Receptor status was used to approximate subtype: estrogen receptor (ER) or progesterone receptor (PR) positive and human epidermal growth factor receptor 2 negative = luminal A; ER + or PR + and HER-2 + = luminal B; ER- and PR- and HER-2 + = HER-2; and ER- and PR- and HER-2- = basal. Competing risks methodology was used to analyze time to local recurrence and distant metastases.ResultsMedian follow-up was 70 months. The overall 5-year cumulative incidence of local recurrence was 1.8% (95% CI, 1.0 to 3.1); 0.8% (0.3, 2.2) for luminal A, 1.5% (0.2, 10) for luminal B, 8.4% (2.2, 30) for HER-2, and 7.1% (3.0, 16) for basal. On multivariable analysis (MVA) with luminal A as baseline, HER-2 (adjusted hazard ratio [AHR] = 9.2; 95% CI, 1.6 to 51; P = .012) and basal (AHR = 7.1; 95% CI, 1.6 to 31; P = .009) subtypes were associated with increased local recurrence. On MVA, luminal B (AHR = 2.9; 95% CI, 1.3 to 6.5; P = .007) and basal (AHR = 2.3; 95% CI, 1.1 to 5.2; P = .035) were associated with increased distant metastases.ConclusionOverall, the 5-year local recurrence rate after BCT was low, but varied by subtype as approximated using ER, PR, and HER-2 status. Local recurrence was particularly low for the luminal A subtype, but was less than 10% at 5 years for all subtypes. Although further follow-up is needed, these results may be useful in counseling patients about their anticipated outcome after BCT.