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Clinical significance of microinvasive breast cancer across the different subtypes and human epidermal growth factor receptor 2 expression levels

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Abstract

Purpose

The clinical behavior, prognosis, and management of microinvasive breast cancer (MiBC) is controversial. We aimed to clarify its significance across different subtypes and the role of human epidermal growth factor receptor 2 (HER2) expression in MiBC.

Methods

We analyzed 1530 patients with T1mi (tumor size ≤ 0.1 cm), node-negative breast cancer who underwent breast conserving surgery or total mastectomy between 2001 and 2020 at the Asan Medical Center (AMC).

Results

When divided into four subtypes, hormone receptor (HR)+/HER2−, HR+ /HER2+ , HR−/HER2+ , and HR−/HER2−, HR−/HER2+ had the highest prevalence rate of 38.5% in MiBC patients. In a median follow-up period of 74 months (0–271 months), 103 (6.7%) patients had recurrent tumor, and 95 (6.2%) had local recurrence. Disease-free survival (DFS) and local recurrence-free survival (LRFS) were worst in the HR−/HER2+ group. The five-year DFS for the HR−/HER2+ group was 92.2%, while it was 97.1% for the HR+/HER2− group (p = 0.024 The five-year LRFS for HER2− patients were better than that of HER2+ MiBC patients, which were 97.1 and 93.8%, respectively (p = 0.010). Univariate and multivariate Cox regression analyses showed that the HR−/HER2+ group had relatively higher risk of recurrence compared to the HR+/HER2− group (hazard ratio [HR] = 2.332, 95% confidence interval [CI] 1.412–3.852, p = 0.001 unadjusted; HR = 3.346, 95% CI 1.408–7.953, p = 0.006 adjusted).

Conclusion

HER2 overexpression was significantly associated with adverse clinicopathologic parameters and increased local recurrence risk in MiBC. Therefore, more understanding of the clinical behavior of HER2 in MiBC will enable tailoring of adjuvant therapy for these patients.

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Data availability

The datasets analyzed during the current study are not publicly available due to protection of personal information of patients, but are available from the corresponding author on reasonable request.

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Funding

This study was supported by a grant ‘Elimination of Cancer Project Fund’ from the Asan Cancer Institute of the Asan Medical Center, Seoul (2017-1341).

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Authors and Affiliations

  1. Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-Gu, Seoul, 05505, Korea

    Soo-Young Lee, Tae-Kyung Yoo, Jisun Kim, Il Yong Chung, Beom Seok Ko, Hee Jeong Kim, Jong Won Lee, Byung Ho Son & Sae Byul Lee

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  1. Soo-Young Lee
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  2. Tae-Kyung Yoo
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  3. Jisun Kim
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  4. Il Yong Chung
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  7. Jong Won Lee
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Soo-Young Lee, Tae-Kyung Yoo, Jisun Kim, Il Yong Chung, Beom Seok Ko, Hee Jeong Kim, Jong Won Lee, Byung Ho Son and Sae Byul Lee. The first draft of the manuscript was written by Soo-Young Lee and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript. We further confirm that the order of authors listed in the manuscript has been approved by all of us. The authors have no relevant financial or non-financial interests to disclose.

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Correspondence to Sae Byul Lee.

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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.

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The study did not involve human subjects due to its retrospective nature, the patients information remain anonymous.

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Lee, SY., Yoo, TK., Kim, J. et al. Clinical significance of microinvasive breast cancer across the different subtypes and human epidermal growth factor receptor 2 expression levels. Breast Cancer Res Treat 200, 47–61 (2023). https://doi.org/10.1007/s10549-023-06955-7

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  • DOI: https://doi.org/10.1007/s10549-023-06955-7

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