Impact of Breast Cancer Subtypes on Prognosis of Women with Operable Invasive Breast Cancer: A Population-based Study Using SEER Database
Impact of Breast Cancer Subtypes on Prognosis of Women with Operable Invasive Breast Cancer: A Population-based Study Using SEER Database
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DOI：
10.1158/1078-0432.ccr-18-2782
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发表时间：
2019-03-15
影响因子：
11.5
通讯作者：
Hwang, Kyu Ri
中科院分区：
文献类型：
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作者：
Hwang, Ki-Tae;Kim, Jongjin;Hwang, Kyu Ri
目的：确定乳腺癌亚型对可手术浸润性乳腺癌女性的预后作用。实验设计：分析了来自监测、流行病学和最终结果 (SEER) 数据库的 321,958 名患者的数据。根据激素受体(HRc)和HER2的状态将乳腺癌亚型分为四类：HRc(+)/HER2(-)、HRc(+)/HER2(+)、HRc(-)/HER2(+)和HRc(-)/HER2(-)。结果：HRc(+)/HER2(-)、HRc(+)/HER2(+)的比例、 HRc(-)/HER2(+)、HRc(-)/HER2(-)和未知亚型分别为70.3%、9.4%、3.9%、10.4%和6.0%。 HRc(+)/HER2(-)显示最高的5年乳腺癌特异性生存率(BCSS)(95.5%)，其次是HRc(+)/HER2(+)(94.1%)、HRc(-)/HER2(+)(89.3%)和HRc(-)/HER2(-)(83.1%)。 HRc(+)/HER2(-)和HRc(+)/HER2(+)的5年总生存率(OS)(分别为88.4%和88.2%)高于HRc(-)/HER2(+)和HRc(-)/HER2(-)(分别为83.9%和76.5%)。无论种族、年龄或阶段如何，HRc(-)/HER2(-) 都表现出最差的 BCSS。尽管BCSS和OS阴性事件亚组中HRc(-)/HER2(-)的比例分别为10.4%和10.2%，但在阳性事件亚组中HRc(-)/HER2(-)比例分别为34.2%和22.7%。亚型是 BCSS 和 OS 的单变量和多变量分析中的重要因素（所有 P < 0.001）。结论：在多变量分析中，乳腺癌亚型是 BCSS 和 OS 的重要独立预后因素。与 HRc(-) 亚型相比，HRc(+) 亚型在 BCSS 和 OS 方面均表现出更好的预后。在 BCSS 和 OS 方面，HRc(-)/HER2(+) 的预后优于 HRc(-)/HER2(-)，但比 HRc(+) 亚型的预后更差。与其他亚型相比，无论种族、年龄或阶段如何，三阴性亚型的 BCSS 表现最差。
Purpose: To determine the prognostic roles of breast cancer subtypes in females with operable invasive breast cancer.Experimental Design: Data of 321,958 patients from Surveillance, Epidemiology, and End Results (SEER) database were analyzed. Breast cancer subtypes were classified into four categories according to the status of hormone receptor (HRc) and HER2: HRc(+)/HER2(-), HRc(+)/HER2(+), HRc(-)/HER2(+), and HRc(-)/HER2(-).Results: Proportions of HRc(+)/HER2(-), HRc(+)/HER2(+), HRc(-)/HER2(+), HRc(-)/HER2(-), and unknown subtype were 70.3%, 9.4%, 3.9%, 10.4%, and 6.0%, respectively. HRc (+)/HER2(-) showed the highest 5-year breast cancer-specific survival (BCSS) rate (95.5%), followed by HRc(+)/HER2(+) (94.1%), HRc(-)/HER2(+) (89.3%), and HRc(-)/HER2(-) (83.1%). HRc(+)/HER2(-) and HRc(+)/HER2(+) showed higher 5-year overall survival (OS) rates (88.4% and 88.2%, respectively) than HRc(-)/HER2(+) and HRc(-)/HER2(-) (83.9% and 76.5%, respectively). HRc(-)/HER2(-) showed the worst BCSS irrespective of race, age, or stage. Although proportions of HRc(-)/HER2(-) in the subgroup with negative event regarding BCSS and OS were 10.4% and 10.2%, respectively, they were 34.2% and 22.7%, respectively, in the subgroup with positive event. Subtype was a significant factor in both univariable and multivariable analyses regarding both BCSS and OS (all P < 0.001).Conclusions: Breast cancer subtype was a significant independent prognostic factor regarding both BCSS and OS in multivariable analyses. HRc(+) subtypes showed better prognosis compared with HRc(-) subtypes regarding both BCSS and OS. HRc(-)/HER2(+) showed better prognosis than HRc(-)/HER2(-) but worse prognosis than HRc(+) subtypes regarding both BCSS and OS. The triple-negative subtype showed the worst BCSS compared with the other subtypes irrespective of race, age, or stage.