Prognosis in women with small (T1mic,T1a,T1b) node-negative operable breast cancer by immunohistochemically selected subtypes

  • G. Cancello
  • P. Maisonneuve
  • N. Rotmensz
  • G. Viale
  • M. G. Mastropasqua
  • G. Pruneri
  • E. Montagna
  • S. Dellapasqua
  • M. Iorfida
  • A. Cardillo
  • P. Veronesi
  • A. Luini
  • M. Intra
  • O. Gentilini
  • E. Scarano
  • A. Goldhirsch
  • M. Colleoni
Clinical trial

Abstract

Knowledge is limited about prognostic significance of breast cancer subtypes among women with small invasive node-negative breast tumours. We explored patterns of recurrence in 1691 women with pT1mic/T1a/T1b, pN0 and M0 breast cancer according to four immunohistochemically defined tumour subtypes: (i) Luminal A (ER-positive, PgR-positive, HER2-negative and Ki-67 < 14%); (ii) Luminal B (ER-positive and/or PgR-positive, HER2-positive and/or Ki-67 ≥ 14%); (iii) HER2-positive, both endocrine receptors absent; and (iv) Triple Negative. At multivariate analysis, women with the Triple Negative breast cancer subtype had an increased risk of loco-regional relapse (LRR) (Hazards Ratio (HR) 3.58; 95%CI: 1.40–9.13) and breast cancer related events (HR 2.18; 95%CI: 1.04–4.57). Overall, Luminal B subtype was not associated with a statistically significant increased risk of recurrence compared with Luminal A, while patients with Luminal B subtype tumours overexpressing HER2 had a 2 fold risk of reduced breast cancer related survival (BCS), but not an increased risk of LRR and distant metastases. Women with HER2 breast cancer subtype had a statistically significant increased risk of LRR (HR 4.53; 95%CI: 1.56–13.1), distant metastases and reduced BCS (HR 3.22; 95%CI: 1.44–7.18) and overall survival (HR 2.87; 95%CI: 1.05–7.89) when compared with the Luminal A subtype, at multivariate analysis. In conclusion, women with small size, node-negative, breast cancer are at higher risk of relapse if with HER2-positive endocrine receptor absent or Triple Negative disease.

Keywords

Breast cancer Prognosis Tumour size Immunohistochemistry Subtypes 

Supplementary material

10549_2011_1465_MOESM1_ESM.doc (60 kb)
Supplementary material 1 (DOC 60 kb)

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Copyright information

© Springer Science+Business Media, LLC. 2011

Authors and Affiliations

  • G. Cancello
    • 1
  • P. Maisonneuve
    • 2
  • N. Rotmensz
    • 2
  • G. Viale
    • 3
    • 4
  • M. G. Mastropasqua
    • 3
  • G. Pruneri
    • 3
  • E. Montagna
    • 1
  • S. Dellapasqua
    • 1
  • M. Iorfida
    • 1
  • A. Cardillo
    • 1
  • P. Veronesi
    • 4
    • 5
  • A. Luini
    • 5
  • M. Intra
    • 5
  • O. Gentilini
    • 5
  • E. Scarano
    • 1
  • A. Goldhirsch
    • 6
  • M. Colleoni
    • 1
  1. 1.Unit of Research in Medical Senology, Division of Medical Oncology, Department of MedicineEuropean Institute of OncologyMilanItaly
  2. 2.Division of Epidemiology and BiostatisticsEuropean Institute of OncologyMilanItaly
  3. 3.Division of PathologyEuropean Institute of OncologyMilanItaly
  4. 4.University of Milan School of MedicineMilanItaly
  5. 5.Division of SenologyEuropean Institute of OncologyMilanItaly
  6. 6.Department of MedicineEuropean Institute of OncologyMilanItaly

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