Clinical Trial

Breast Cancer Research and Treatment

, Volume 115, Issue 2, pp 349-358

Short-term outcome of primary operated early breast cancer by hormone and HER-2 receptors

  • Olivier BrouckaertAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Gynecological Oncology, UZLeuven
  • , Saskia PintensAffiliated withDepartment of Pathology, UZLeuvenDepartment of Gynecological Oncology, UZLeuven
  • , Vanya Van BelleAffiliated withElectrical Engineering, ESAT, UZLeuven
  • , Sabine Van HuffelAffiliated withElectrical Engineering, ESAT, UZLeuven
  • , Edward CamerlynckAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Gynecological Oncology, UZLeuven
  • , Frédéric AmantAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Gynecological Oncology, UZLeuven
  • , Karin LeunenAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Gynecological Oncology, UZLeuven
  • , An SmeetsAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Surgery, UZLeuven
  • , Patrick BertelootAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Gynecological Oncology, UZLeuven
    • , Erik Van LimbergenAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Radiotherapy, UZLeuven
    • , Julie DecockAffiliated withMultidisciplinary Breast Centre, UZLeuven
    • , Wouter HendrickxAffiliated withMultidisciplinary Breast Centre, UZLeuven
    • , Caroline WeltensAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Radiotherapy, UZLeuven
    • , Walter Van den BogaertAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Radiotherapy, UZLeuven
    • , Isabelle Vanden BemptAffiliated withDepartment of Pathology, UZLeuven
    • , Maria DrijkoningenAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Pathology, UZLeuven
    • , Robert ParidaensAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Medical Oncology, UZLeuven
    • , Hans WildiersAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Medical Oncology, UZLeuven
    • , Ignace VergoteAffiliated withDepartment of Gynecological Oncology, UZLeuven
    • , Marie-Rose ChristiaensAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Surgery, UZLeuven
    • , Patrick NevenAffiliated withMultidisciplinary Breast Centre, UZLeuvenDepartment of Gynecological Oncology, UZLeuven Email author 

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Abstract

Introduction Prognostic subgroup classification of operable breast cancers using cDNA clustering of breast cancer-related genes resembles the classification based on the combined immunohistochemical (IHC) expression of the hormone and HER-2 receptors. We here report the short-term disease-free interval (DFI) of operable breast cancers by their joint hormone receptor/HER-2 phenotype. Patients and methods Short-term follow-up (FU) of a prospective cohort of 1,958 breast-cancer patients primary operated at our institution between 2000 and 2005. Receptors were evaluated using IHC. Steroid receptors were considered positive for any nuclear staining; HER-2 for strong (3+) membrane staining or positive fluorescence in situ hybridization (FISH). Kaplan–Meier (KM) DFI curves were calculated for any relapse defined as a local, regional, contralateral, or distant breast cancer event for the six predefined breast cancer subgroups: ER + PR + HER-2 − (PPN), ER + PR − HER-2 − (PNN), ER + PR + HER-2 + (PPP), ER – PR − HER-2 − (NNN), ER – PR − HER-2 + (NNP), and ER + PR − HER-2 + (PNP). P-values were calculated for comparison of the six different survival curves using two possible adaptations for multiple testing. A multivariate model for the receptors predicting DFI did incorporate local and systemic adjuvant therapy. Results Median patient age was 57 years (ranges 26–96) and median FU was 3.35 years. Overall, DFI at median FU was 91%; 94% for PPN, 89% for PNN, 86% for NNN, 81% for PPP, 80% for PNP, and 76% for NNP cases. Some receptor subgroups had a significantly better DFI than others based on multiple testing, especially when the PPN group was compared against the four most frequent subtypes. The multivariate model with local and systemic adjuvant therapy confirmed the prognostic value of ER, PR, and HER-2 for short-term DFI. Conclusion It is possible to distinguish short-term prognostic breast cancer subgroups only on the basis of ER, PR, and HER-2 even when stratified for local and systemic adjuvant therapy. While gene expression profiles based on microarray data of over hundreds of genes will probably teach us much about breast cancer biology, heterogeneity, and prognosis, we emphasize the important short-term prognostic value of currently used IHC markers for ER, PR, and HER-2.

Keywords

Breast cancer Disease free survival Disease free interval HER-2 Steroid receptors Estrogen receptor Progesterone receptor