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Outcome evaluation in pre-trastuzumab era between different breast cancer phenotypes: a population-based study on Italian women.
Tumori. 2012 Nov; 98(6):743-50.T

Abstract

AIMS AND BACKGROUND

Based on estrogen receptor (ER), progesterone receptor (PgR) and Her2/neu (HER2) expression, four breast cancer subtypes have been distinguished: luminal A (ER and/or PgR/HER2-, Ki67 <14%), luminal B (ER and/or PgR/HER2-, Ki67 ≥14% or ER and/or PgR/HER2), triple-negative (ER-/PgR-/HER2-), and HER2 (ER-/PgR-/HER2). Our aim was to evaluate the prognosis of these phenotypes in the pre-trastuzumab era in a large cohort of Italian women.

METHODS AND STUDY DESIGN

We studied 2347 breast cancer patients, in stage I-II, registered by the Modena Cancer Registry from 1999 to 2006 in the Modena province, Italy. Overall survival, disease-free survival and second non-mammary tumors were evaluated.

RESULTS

A total of 1868 luminal A (79.6%), 195 luminal B (8.3%), 205 triple-negative (8.7%) and 79 HER2 (3.4%) patients were identified. A better prognosis was observed for luminal A than for luminal B, HER2 and triple-negative subtypes (5-year overall survival, 91% vs 89% vs 87% vs 86%, respectively, P <0.001). Disease-free survival for pT1a and pT1b tumors was worse in HER2 (82%) than in triple-negative (90%), luminal B (95%) and luminal A (97%) (P = 0.013). Finally, luminal B patients had a significantly higher rate of second non-mammary tumors than the other groups.

CONCLUSIONS

In the pre-trastuzumab era, luminal A patients showed a better 5-year overall survival than luminal B, HER2 and triple-negative patients, but in terms of disease-free survival, HER2 subtype represented an unfavorable group over time, whereas the triple-negative group had an increased risk of relapse in the first 42 months and then decreased. Among each prognostic factor, ER <10%, Ki67 >14% and HER2 overexpression are considered as risk factors, but only HER2 positivity seems to preserve the role over time.

Authors+Show Affiliations

Department of Oncology and Hematology, University of Modena and Reggio Emilia, Via del Pozzo 71, Modena, Italy. hbc@unimore.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

23389361

Citation

Cortesi, Laura, et al. "Outcome Evaluation in Pre-trastuzumab Era Between Different Breast Cancer Phenotypes: a Population-based Study On Italian Women." Tumori, vol. 98, no. 6, 2012, pp. 743-50.
Cortesi L, De Matteis E, Cirilli C, et al. Outcome evaluation in pre-trastuzumab era between different breast cancer phenotypes: a population-based study on Italian women. Tumori. 2012;98(6):743-50.
Cortesi, L., De Matteis, E., Cirilli, C., Marcheselli, L., Proietto, M., & Federico, M. (2012). Outcome evaluation in pre-trastuzumab era between different breast cancer phenotypes: a population-based study on Italian women. Tumori, 98(6), 743-50. https://doi.org/10.1700/1217.13498
Cortesi L, et al. Outcome Evaluation in Pre-trastuzumab Era Between Different Breast Cancer Phenotypes: a Population-based Study On Italian Women. Tumori. 2012;98(6):743-50. PubMed PMID: 23389361.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcome evaluation in pre-trastuzumab era between different breast cancer phenotypes: a population-based study on Italian women. AU - Cortesi,Laura, AU - De Matteis,Elisabetta, AU - Cirilli,Claudia, AU - Marcheselli,Luigi, AU - Proietto,Manuela, AU - Federico,Massimo, PY - 2013/2/8/entrez PY - 2013/2/8/pubmed PY - 2013/3/30/medline SP - 743 EP - 50 JF - Tumori JO - Tumori VL - 98 IS - 6 N2 - AIMS AND BACKGROUND: Based on estrogen receptor (ER), progesterone receptor (PgR) and Her2/neu (HER2) expression, four breast cancer subtypes have been distinguished: luminal A (ER and/or PgR/HER2-, Ki67 <14%), luminal B (ER and/or PgR/HER2-, Ki67 ≥14% or ER and/or PgR/HER2), triple-negative (ER-/PgR-/HER2-), and HER2 (ER-/PgR-/HER2). Our aim was to evaluate the prognosis of these phenotypes in the pre-trastuzumab era in a large cohort of Italian women. METHODS AND STUDY DESIGN: We studied 2347 breast cancer patients, in stage I-II, registered by the Modena Cancer Registry from 1999 to 2006 in the Modena province, Italy. Overall survival, disease-free survival and second non-mammary tumors were evaluated. RESULTS: A total of 1868 luminal A (79.6%), 195 luminal B (8.3%), 205 triple-negative (8.7%) and 79 HER2 (3.4%) patients were identified. A better prognosis was observed for luminal A than for luminal B, HER2 and triple-negative subtypes (5-year overall survival, 91% vs 89% vs 87% vs 86%, respectively, P <0.001). Disease-free survival for pT1a and pT1b tumors was worse in HER2 (82%) than in triple-negative (90%), luminal B (95%) and luminal A (97%) (P = 0.013). Finally, luminal B patients had a significantly higher rate of second non-mammary tumors than the other groups. CONCLUSIONS: In the pre-trastuzumab era, luminal A patients showed a better 5-year overall survival than luminal B, HER2 and triple-negative patients, but in terms of disease-free survival, HER2 subtype represented an unfavorable group over time, whereas the triple-negative group had an increased risk of relapse in the first 42 months and then decreased. Among each prognostic factor, ER <10%, Ki67 >14% and HER2 overexpression are considered as risk factors, but only HER2 positivity seems to preserve the role over time. SN - 2038-2529 UR - https://www.unboundmedicine.com/medline/citation/23389361/Outcome_evaluation_in_pre_trastuzumab_era_between_different_breast_cancer_phenotypes:_a_population_based_study_on_Italian_women_ L2 - https://journals.sagepub.com/doi/10.1700/1217.13498?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -