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Differential survival and recurrence patterns of patients operated for breast cancer according to the new immunohistochemical classification: analytical survey from 1997 to 2012

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Tumor Biology

Abstract

Breast cancer can no longer be considered only one condition. It should be regarded rather as a heterogeneous group of diseases with different molecular outlines. The aim of this study is to establish a correlation between immunohistochemical tumor sub-typing and surgical treatment, local recurrence rates, distant metastases, and cancer-specific mortality at 5 and 10 years. At least, four tumor sub-types have been described, which were associated with variable risk factors, different natural clinical course, and different response to both local and systemic therapies. For Luminal A: ER + and/or PR + HER2− Ki67 <15 %; Luminal B: ER + and/or PR + HER2− Ki67 ≥15 %; Pure HER2: ER-PR-HER2+; Triple Negative: ER-PR-HER2−. One thousand four hundred seventy-seven patients operated for 1,511 invasive breast tumors were included. Disease-free survival, overall mortality, and breast cancer-specific mortality at 5 and 10 years were calculated. Distant metastases prevalence ranged from 8 to 28 % across sub-types, increasing stepwise from Luminal A, Luminal B, and pure HER2 through triple negative. Conversely, larger tumors with significant axillary burden were more likely to belong to HER2 or triple negative groups. Luminal A sub-type patients showed significantly lower mortality rates both overall and specific at 5 and 10 years, as compared to the rest. Luminal B patients showed lower mortality rates only when compared with triple negative patients. Simple classification of breast cancer patients based on immunohistochemistry and other risk factors is quite useful to establish groups with bad or even worse prognosis. Although results from immunohistochemical classification were not taken into account for surgical procedure decision-making, we found that pure HER2 and triple negative patients received nevertheless higher rates of radical treatment.

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Acknowledgments

We wish to thank Ms. Patricia Vigués for correcting the manuscript, Mr. Manel Martori for helping us with the tables and graphs, and finally to the staff of the Breast Cancer Screening Unit: Cristina, Pilar, and Sandra, as well as to the staff of the Pathology Department (University Hospital of Mútua Terrassa): Francisca, Maria Teresa, and Maribel; all of them were essential contributors in keeping our breast cancer database updated.

Conflicts of interest

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Author information

Authors and Affiliations

  1. Breast Unit, Department of Gynecology, CTD, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, C/ Sant Antoni 20, 08221, Terrassa, Spain

    Antonio García Fernández & Israel Barco

  2. Department of Gynecology, Catalan Institute of Health, Mollet del Vallès, Barcelona, Spain

    Antonio García Fernández

  3. Department of Nursing, School of Health Science TecnoCampus Mataró-Maresme, Mataro, Barcelona, Spain

    Carol Chabrera

  4. Department of Hemato-oncology, Catalan Institute of Oncology, Catalonia, Spain

    Carol Chabrera

  5. International University of Catalonia, Catalonia, Spain

    Marc García Font

  6. Nuclear Medicine Department, CTD, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Barcelona, Spain

    Manel Fraile

  7. Department of Hemato-oncology, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Barcelona, Spain

    Sonia Gónzalez & Lluís Cirera

  8. Department of Pathology, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Barcelona, Spain

    Clarisa González

  9. Department of Surgery, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Barcelona, Spain

    Enrique Veloso

  10. Breast Unit, Department of Gynecology, Hospital of Terrassa, Health Consortium of Terrassa, Terrassa, Spain

    José María Lain

  11. Department of Gynecology, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Barcelona, Spain

    Antoni Pessarrodona

  12. Research Unit, Research Foundation Mútua Terrassa, University of Barcelona, Barcelona, Spain

    Nuria Giménez

  13. Laboratory of Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain

    Nuria Giménez

Authors
  1. Antonio García Fernández
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  2. Carol Chabrera
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  3. Marc García Font
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  4. Manel Fraile
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  5. Sonia Gónzalez
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  6. Israel Barco
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  7. Clarisa González
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  8. Lluís Cirera
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  9. Enrique Veloso
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  10. José María Lain
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  11. Antoni Pessarrodona
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  12. Nuria Giménez
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Corresponding author

Correspondence to Antonio García Fernández.

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García Fernández, A., Chabrera, C., García Font, M. et al. Differential survival and recurrence patterns of patients operated for breast cancer according to the new immunohistochemical classification: analytical survey from 1997 to 2012. Tumor Biol. 34, 2349–2355 (2013). https://doi.org/10.1007/s13277-013-0782-3

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  • DOI: https://doi.org/10.1007/s13277-013-0782-3

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