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Impact of triple negative phenotype on breast cancer prognosis.
Breast J. 2008 Sep-Oct; 14(5):456-63.BJ

Abstract

Triple negative (TN) [estrogen receptor (ER), progesterone receptor (PgR)] (ER-/PgR-/Her2/neu-) breast cancer (BC) is an aggressive disease without tumor-specific treatment options. Our objective is to evaluate the relative contribution of combined Her2/neu (Her2) and hormone receptor (HR) status to BC progression. A prospective primary BC cohort of 1550 patients at our institution, stage I-IV, from 1998 to 2003 were categorized by HR and Her2 status into ER+/PgR+/Her2- (HR+/Her2-) (n = 1134), ER+/PgR+/Her2+ [triple positive (TP)] (n = 138), ER-/PgR-/Her2- (TN) (n = 183), and ER-/PgR-/Her2+ (HR-/Her2+) (n = 95). Clinical variables were chart abstracted and vital and disease status updated annually. Log-rank tests and Cox regression analyses were used to assess associations with survival. Patient age ranged from 21 to 88 years and average length of follow-up was 4.24 years. Overall survival at 5 years was 94% (HR+/Her2-), 91% (TP), and 81% (TN and HR-/Her2+) (log rank test = 22.22, p < 0.001). Disease-specific survival at 5 years was 98% (HR+/Her2-), 93% (TP), 88% (TN), and 86% (HR-/Her2+) (log rank test = 25.85, p < 0.001) and 5-year relapse-free survival was 95% (HR+/Her2-), 89% (TP), 84% (TN), and 76% (HR-/Her2+) (log rank test = 20.29, p < 0.001). In a model adjusted for age, race, TNM stage, and treatment using HR+/Her2- patients as the reference group, recurrence risk was 1.98 for TP (95% CI = 1.02 to 3.84), 2.32 for TN (95% CI = 1.32 to 4.08), and 4.25 for HR-/Her2+ patients (95% CI = 2.33, 7.75). A hierarchy of BC phenotypes defined by HR and Her2 status exists with progressively worse disease outcomes by category.

Authors+Show Affiliations

Swedish Cancer Institute at Swedish Medical Center, Swedish Cancer Institute, Seattle, WA, USA. hank.kaplan@swedish.orgNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18657139

Citation

Kaplan, Henry G., and Judith A. Malmgren. "Impact of Triple Negative Phenotype On Breast Cancer Prognosis." The Breast Journal, vol. 14, no. 5, 2008, pp. 456-63.
Kaplan HG, Malmgren JA. Impact of triple negative phenotype on breast cancer prognosis. Breast J. 2008;14(5):456-63.
Kaplan, H. G., & Malmgren, J. A. (2008). Impact of triple negative phenotype on breast cancer prognosis. The Breast Journal, 14(5), 456-63. https://doi.org/10.1111/j.1524-4741.2008.00622.x
Kaplan HG, Malmgren JA. Impact of Triple Negative Phenotype On Breast Cancer Prognosis. Breast J. 2008 Sep-Oct;14(5):456-63. PubMed PMID: 18657139.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of triple negative phenotype on breast cancer prognosis. AU - Kaplan,Henry G, AU - Malmgren,Judith A, Y1 - 2008/07/24/ PY - 2008/7/29/pubmed PY - 2008/12/17/medline PY - 2008/7/29/entrez SP - 456 EP - 63 JF - The breast journal JO - Breast J VL - 14 IS - 5 N2 - Triple negative (TN) [estrogen receptor (ER), progesterone receptor (PgR)] (ER-/PgR-/Her2/neu-) breast cancer (BC) is an aggressive disease without tumor-specific treatment options. Our objective is to evaluate the relative contribution of combined Her2/neu (Her2) and hormone receptor (HR) status to BC progression. A prospective primary BC cohort of 1550 patients at our institution, stage I-IV, from 1998 to 2003 were categorized by HR and Her2 status into ER+/PgR+/Her2- (HR+/Her2-) (n = 1134), ER+/PgR+/Her2+ [triple positive (TP)] (n = 138), ER-/PgR-/Her2- (TN) (n = 183), and ER-/PgR-/Her2+ (HR-/Her2+) (n = 95). Clinical variables were chart abstracted and vital and disease status updated annually. Log-rank tests and Cox regression analyses were used to assess associations with survival. Patient age ranged from 21 to 88 years and average length of follow-up was 4.24 years. Overall survival at 5 years was 94% (HR+/Her2-), 91% (TP), and 81% (TN and HR-/Her2+) (log rank test = 22.22, p < 0.001). Disease-specific survival at 5 years was 98% (HR+/Her2-), 93% (TP), 88% (TN), and 86% (HR-/Her2+) (log rank test = 25.85, p < 0.001) and 5-year relapse-free survival was 95% (HR+/Her2-), 89% (TP), 84% (TN), and 76% (HR-/Her2+) (log rank test = 20.29, p < 0.001). In a model adjusted for age, race, TNM stage, and treatment using HR+/Her2- patients as the reference group, recurrence risk was 1.98 for TP (95% CI = 1.02 to 3.84), 2.32 for TN (95% CI = 1.32 to 4.08), and 4.25 for HR-/Her2+ patients (95% CI = 2.33, 7.75). A hierarchy of BC phenotypes defined by HR and Her2 status exists with progressively worse disease outcomes by category. SN - 1524-4741 UR - https://www.unboundmedicine.com/medline/citation/18657139/Impact_of_triple_negative_phenotype_on_breast_cancer_prognosis_ L2 - https://doi.org/10.1111/j.1524-4741.2008.00622.x DB - PRIME DP - Unbound Medicine ER -