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The prognostic value of HER2 status and efficacy of anti-HER2 therapy in patients with HR-positive mucinous breast cancer: a nationwide study from the Korean Breast Cancer Society

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

A Letter to the Editor to this article was published on 11 March 2020

Abstract

Purpose

The effect of human epidermal growth factor receptor 2 (HER2) status on mucinous carcinoma (MC) of the breast is unknown due to the rarity of HER2-positive cases. We evaluated the prognostic value of HER2 status and the efficacy of anti-HER2 therapy in patients with hormone receptor (HR)-positive MC.

Methods

From the data of 154,661 patients recorded in the Korean Breast Cancer Registry between January 1990 and August 2016, 3076 (2.0%) were diagnosed with MC. Overall survival (OS) according to HER2 status and anti-HER2 therapy was analyzed using Kaplan–Meier estimates. Multivariate analysis was performed using the Cox proportional hazards model to estimate the adjusted hazards ratio (HR) for clinicopathologic factors.

Results

A total of 2716 HR-positive MC patients were enrolled and followed up for a median 100.1 months. Of these, 2094 (77.1%) were HER2-negative and 228 (8.4%) were HER2-positive. HR-positive, HER2-positive MC patients had more advanced pathologic tumor stages (T3 or T4) (p = 0.001), more axillary lymph node involvement (p < 0.001), higher nuclear grade (p < 0.001), and more lymphovascular invasion (p = 0.012) than HER2-negative patients. Subgroup analysis of HR-positive, node-positive MC showed that HER2-positive MC was an independent prognostic factor for OS (HR = 2.657; 95% CI, 1.665–4.241; p < 0.001). HR-positive, node-positive, and HER2-negative MC had significantly longer OS than HER2-positive MBC (p = 0.017). The node-positive subgroup that received anti-HER2 therapy had increased OS, although not significantly (p = 0.224).

Conclusion

Our nationwide database study revealed that HER2-positive status was associated with worse prognosis in HR-positive and node-positive MC. Anti-HER2 therapy might be beneficial in HR-positive, node-positive, and HER2-positive MC.

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Abbreviations

CI:

Confidence interval

ER:

Estrogen receptor

HER2:

Human epidermal growth factor receptor 2

HR:

Hormone receptor

IDC:

Invasive duct carcinoma

KBCR:

Korean Breast Cancer Registry

MC:

Mucinous carcinoma

OS:

Overall survival

PR:

Progesterone receptor

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Acknowledgements

This work was supported the Basic Science Research Program of the National Research Foundation funded by the Ministry of Education (2017R1D1A1B03033486).

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Authors and Affiliations

  1. Division of Breast Surgery, Department of Surgery, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea

    Hyung Suk Kim

  2. Division of Breast Surgery, Department of Surgery, Seoul St. Mary’s Hospital, The Catholic University of Medicine, Seoul, Korea

    Tae Kyung Yoo & Woo Chan Park

  3. Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, Korea

    Byung Joo Chae

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  1. Hyung Suk Kim
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Correspondence to Byung Joo Chae.

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Kim, H.S., Yoo, T.K., Park, W.C. et al. The prognostic value of HER2 status and efficacy of anti-HER2 therapy in patients with HR-positive mucinous breast cancer: a nationwide study from the Korean Breast Cancer Society. Breast Cancer Res Treat 180, 461–470 (2020). https://doi.org/10.1007/s10549-020-05550-4

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