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Long-term prognostic effect of hormone receptor subtype on breast cancer

  • Ki-Tae HwangEmail author
  • Jongjin Kim
  • Jiwoong Jung
  • Byoung Hyuck Kim
  • Jeong Hwan Park
  • Sook Young Jeon
  • Kyu Ri Hwang
  • Eun Youn Roh
  • Jin Hyun Park
  • Su-jin Kim
Clinical trial
  • 84 Downloads

Abstract

Purpose

To determine the long-term prognostic role of hormone receptor subtype in breast cancer using surveillance, epidemiology, and end results (SEER) database.

Methods

Data of 810,587 female operable invasive breast cancer patients from SEER database with a mean follow-up period of 94.2 months (range, 0–311 months) were analyzed. Hormone receptor subtype was classified into four groups based on estrogen receptor (ER) and progesterone receptor (PR) statuses: ER(+)/PR(+), ER(+)/PR(−), ER(−)/PR(+), and ER(−)/PR(−).

Results

Numbers of subjects with ER(+)/PR(+), ER(+)/PR(−), ER(−)/PR(+), ER(−)/PR(−), and unknown were 496,279 (61.2%), 86,858 (10.7%), 11,545 (1.4%), 135,441 (16.7%), and 80,464 (9.9%), respectively. The ER(+)/PR(+) subtype showed the best breast-cancer-specific survival, followed by ER(+)/PR(−), ER(−)/PR(+), and ER(−)/PR(−) subtypes in the respective order (all p < 0.001). Survival difference among hormone receptor subtypes was maintained in subgroup analysis according to anatomic stage, race, age group, and year of diagnosis. Hormone receptor subtype was a significant independent prognostic factor in multivariable analyses (p < 0.001). Hazard ratios of ER(+)/PR(−), ER(−)/PR(+), and ER(−)/PR(−) for breast-cancer-specific mortality risk were 1.419 (95% confidence interval [CI] 1.383–1.456), 1.630 (95% CI 1.537–1.729), and 1.811 (95% CI 1.773–1.848), respectively, with ER(+)/PR(+) as reference.

Conclusion

Hormone receptor subtype is a significant independent prognostic factor in female operable invasive breast cancer patients with long-term effect. The ER(+)/PR(+) subtype shows the most favorable prognosis, followed by ER(+)/PR(−), ER(−)/PR(+), and ER(−)/PR(−) subtypes in the respective order. Prognostic impacts of hormone receptor subtypes are also maintained in subgroup analysis according to anatomic stage, race, age, and year of diagnosis.

Keywords

Breast neoplasms Hormone receptor Prognosis SEER Subtype 

Abbreviations

CI

Confidence interval

ER

Estrogen receptor

HER2

Human epidermal growth factor receptor 2

HR

Hazard ratio

PR

Progesterone receptor

SEER

Surveillance, epidemiology, and end results

Notes

Acknowledgements

We appreciate valuable discussion from the members of the Boramae hospital Breast cancer Study group (BBS). Ki-Tae Hwang, MD, PhD (Department of Surgery); Bo Kyung Koo, MD, PhD (Department of Internal Medicine); Byoung Hyuck Kim, MD (Department of Radiation Oncology) Young A. Kim, MD, PhD (Department of Pathology); Jongjin Kim, MD (Department of Surgery); Eun Youn Roh, MD, PhD (Department of Laboratory Medicine); Sejung Maeng, PhD (Department of Surgery); Sung Bae Park, MD (Department of Neurosurgery); Jin Hyun Park, MD, MS (Department of Internal Medicine); Cho Won Park, RN (Department of Surgery); Bumjo Oh, MD (Department of Family Medicine); So Won Oh, MD, PhD (Department of Nuclear Medicine); Sohee Oh, PhD (Department of Biostatistics); Jong Yoon Lee, MD, MS (Department of Radiology); Ji Hyun Chang, MD, PhD (Department of Radiation Oncology); Se Hee Jung, MD, PhD (Department of Rehabilitation Medicine); Young Jun Chai, MD, MS (Department of Surgery); In Sil Choi, MD, PhD (Department of Internal Medicine); A. Jung Chu, MD (Department of Radiology); Kyu Ri Hwang, MD, PhD (Department of Obstetrics and Gynecology). All BBS members are from the Seoul Metropolitan Government Seoul National University Boramae Medical Center (39, Boramae-Gil, Dongjak-gu, Seoul, 156-707, Republic of Korea).

Funding

The research for this manuscript was not financially supported, and none of the authors had any relevant financial relationships.

Compliance with ethical standards

Conflict of interest

All the authors declare that are no actual or potential conflicts of interest. The institutional review boards approved this study (Seoul Metropolitan Government Seoul National University Boramae Medical Center, 07-2019-2).

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The institutional review boards approved this study (Seoul Metropolitan Government Seoul National University Boramae Medical Center, 07-2019-2).

Informed consent

For this type of study formal consent is not required.

Research involving human participants and/or animals

This article does not contain any studies with animals performed by any of the authors.

Supplementary material

10549_2019_5456_MOESM1_ESM.docx (546 kb)
Supplementary material 1 (DOCX 546 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of SurgerySeoul Metropolitan Government Seoul National University Boramae Medical CenterSeoulRepublic of Korea
  2. 2.Department of SurgerySeoul Medical CenterSeoulRepublic of Korea
  3. 3.Department of Radiation OncologySeoul Metropolitan Government Seoul National University Boramae Medical CenterSeoulRepublic of Korea
  4. 4.Department of PathologySeoul Metropolitan Government Seoul National University Boramae Medical CenterSeoulRepublic of Korea
  5. 5.Department of Surgery, Graduate SchoolKyung Hee UniversitySeoulRepublic of Korea
  6. 6.Department of Obstetrics and GynecologySeoul Metropolitan Government Seoul National University Boramae Medical CenterSeoulRepublic of Korea
  7. 7.Department of Laboratory MedicineSeoul Metropolitan Government Seoul National University Boramae Medical CenterSeoulRepublic of Korea
  8. 8.Department of Internal MedicineSeoul Metropolitan Government Seoul National University Boramae Medical CenterSeoulRepublic of Korea
  9. 9.Department of SurgerySeoul National University College of MedicineSeoulRepublic of Korea

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