Skip to main content

Advertisement

Log in

Outcomes and recurrence patterns according to breast cancer subtypes in Korean women

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

Abstract

The aim of this study was to evaluate the outcomes and patterns of recurrence in the different subtypes of breast cancer. We analyzed 1432 stage I–III breast cancer patients who had undergone surgery at Seoul National University Bundang Hospital between June 2003 and August 2011. Five subtypes were defined according to estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 (HER2), and Ki-67. Overall survival (OS) and breast cancer-free interval (BCFI) rates were estimated using the Kaplan–Meier method. Site-specific recurrence was estimated using Gray’s test. The median follow-up period was 53 months. There were 22 local recurrences, 18 cases of contralateral breast cancer, 19 regional nodal recurrences, and 70 distant metastases. The 5-year BCFIs by subtype were luminal B-HER2 (+), 94.2 %; luminal A, 93.9 %; luminal B-HER2 (−), 91.4 %; HER2, 83.1 %; and triple-negative, 81.9 % (p < 0.001). Cases with the luminal A had a 5-year OS rate of 98.3 % that was the longest compared to those of cases with luminal B-HER2 (−), 95.8 %; luminal B-HER2 (+), 98.0 %; HER2, 90.8 %; and triple-negative, 89.9 % (p < 0.001). The triple-negative had a higher rate of local recurrence at the first site than others (p = 0.013). HER2 and triple-negative had higher rates of nodal recurrence at the first site than others (p < 0.001). The outcomes and patterns of site-specific recurrence in Korean breast cancer patients were different for each subtype. Defining recurrence patterns by breast cancer subtypes can help determine the appropriate method of surveillance and treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, Pollack JR, Ross DT, Johnsen H, Akslen LA, Fluge O, Pergamenschikov A, Williams C, Zhu SX, Lonning PE, Borresen-Dale AL, Brown PO, Botstein D (2000) Molecular portraits of human breast tumours. Nature 406(6797):747–752. doi:10.1038/35021093

    Article  CAS  PubMed  Google Scholar 

  2. van de Vijver MJ, He YD, van’t Veer LJ, Dai H, Hart AA, Voskuil DW, Schreiber GJ, Peterse JL, Roberts C, Marton MJ, Parrish M, Atsma D, Witteveen A, Glas A, Delahaye L, van der Velde T, Bartelink H, Rodenhuis S, Rutgers ET, Friend SH, Bernards R (2002) A gene-expression signature as a predictor of survival in breast cancer. N Engl J Med 347(25):1999–2009. doi:10.1056/NEJMoa021967

    Article  PubMed  Google Scholar 

  3. Sotiriou C, Neo SY, McShane LM, Korn EL, Long PM, Jazaeri A, Martiat P, Fox SB, Harris AL, Liu ET (2003) Breast cancer classification and prognosis based on gene expression profiles from a population-based study. Proc Natl Acad Sci USA 100(18):10393–10398. doi:10.1073/pnas.1732912100

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  4. Sorlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H, Hastie T, Eisen MB, van de Rijn M, Jeffrey SS, Thorsen T, Quist H, Matese JC, Brown PO, Botstein D, Lonning PE, Borresen-Dale AL (2001) Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA 98(19):10869–10874. doi:10.1073/pnas.191367098

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  5. Riley RD, Abrams KR, Sutton AJ, Lambert PC, Jones DR, Heney D, Burchill SA (2003) Reporting of prognostic markers: current problems and development of guidelines for evidence-based practice in the future. Br J Cancer 88(8):1191–1198. doi:10.1038/sj.bjc.6600886

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Lowery AJ, Kell MR, Glynn RW, Kerin MJ, Sweeney KJ (2012) Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype. Breast Cancer Res Treat 133(3):831–841. doi:10.1007/s10549-011-1891-6

    Article  PubMed  Google Scholar 

  7. Mersin H, Gulben K, Berberoglu U, Yazi M, Acun G, Kinas V, Erdogan S (2011) Prognostic factors affecting postmastectomy locoregional recurrence in patients with early breast cancer: are intrinsic subtypes effective? World J Surg 35(10):2196–2202. doi:10.1007/s00268-011-1240-2

    Article  PubMed  Google Scholar 

  8. Onitilo AA, Engel JM, Greenlee RT, Mukesh BN (2009) Breast cancer subtypes based on ER/PR and Her2 expression: comparison of clinicopathologic features and survival. Clin Med Res 7(1–2):4–13. doi:10.3121/cmr.2009.825

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  9. Voduc KD, Cheang MC, Tyldesley S, Gelmon K, Nielsen TO, Kennecke H (2010) Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol 28(10):1684–1691. doi:10.1200/jco.2009.24.9284

    Article  PubMed  Google Scholar 

  10. Nguyen PL, Taghian AG, Katz MS, Niemierko A, Abi Raad RF, Boon WL, Bellon JR, Wong JS, Smith BL, Harris JR (2008) Breast cancer subtype approximated by estrogen receptor, progesterone receptor, and HER-2 is associated with local and distant recurrence after breast-conserving therapy. J Clin Oncol 26(14):2373–2378. doi:10.1200/jco.2007.14.4287

    Article  PubMed  Google Scholar 

  11. Metzger-Filho O, Sun Z, Viale G, Price KN, Crivellari D, Snyder RD, Gelber RD, Castiglione-Gertsch M, Coates AS, Goldhirsch A, Cardoso F (2013) Patterns of recurrence and outcome according to breast cancer subtypes in lymph node-negative disease: results from international breast cancer study group trials VIII and IX. J Clin Oncol 31(25):3083–3090. doi:10.1200/jco.2012.46.1574

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  12. Goldhirsch A, Winer EP, Coates AS, Gelber RD, Piccart-Gebhart M, Thurlimann B, Senn HJ, Panel Members (2013) Personalizing the treatment of women with early breast cancer: highlights of the St Gallen international expert consensus on the primary therapy of early breast cancer 2013. Ann Oncol 24(9):2206–2223. doi:10.1093/annonc/mdt303

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  13. Ribelles N, Perez-Villa L, Jerez JM, Pajares B, Vicioso L, Jimenez B, de Luque V, Franco L, Gallego E, Marquez A, Alvarez M, Sanchez-Munoz A, Perez-Rivas L, Alba E (2013) Pattern of recurrence of early breast cancer is different according to intrinsic subtype and proliferation index. Breast Cancer Res 15(5):R98. doi:10.1186/bcr3559

    Article  PubMed Central  PubMed  Google Scholar 

  14. Park S, Koo JS, Kim, Park HS, Lee JS, Lee JS, Kim SI, Park BW (2012) Characteristics and outcomes according to molecular subtypes of breast cancer as classified by a panel of four biomarkers using immunohistochemistry. Breast (Edinburgh, Scotland) 21(1):50–57. doi:10.1016/j.breast.2011.07.008

    Article  Google Scholar 

  15. Ahn SG, Lee HM, Lee SA, Jeong J, Lee HD (2014) Long-term survival analysis of korean breast cancer patients at a single center: improving outcome over time. Yonsei Med J 55(5):1187–1195. doi:10.3349/ymj.2014.55.5.1187

    Article  PubMed Central  PubMed  Google Scholar 

  16. Malone KE, Begg CB, Haile RW, Borg A, Concannon P, Tellhed L, Xue S, Teraoka S, Bernstein L, Capanu M, Reiner AS, Riedel ER, Thomas DC, Mellemkjaer L, Lynch CF, Boice JD Jr, Anton-Culver H, Bernstein JL (2010) Population-based study of the risk of second primary contralateral breast cancer associated with carrying a mutation in BRCA1 or BRCA2. J Clin Oncol 28(14):2404–2410. doi:10.1200/jco.2009.24.2495

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  17. Kim MJ, Ro JY, Ahn SH, Kim HH, Kim SB, Gong G (2006) Clinicopathologic significance of the basal-like subtype of breast cancer: a comparison with hormone receptor and Her2/neu-overexpressing phenotypes. Hum Pathol 37(9):1217–1226. doi:10.1016/j.humpath.2006.04.015

    Article  CAS  PubMed  Google Scholar 

  18. Shim HJ, Kim SH, Kang BJ, Choi BG, Kim HS, Cha ES, Song BJ (2014) Breast cancer recurrence according to molecular subtype. Asian Pac J Cancer Prev 15(14):5539–5544

    Article  PubMed  Google Scholar 

  19. Hess KR, Pusztai L, Buzdar AU, Hortobagyi GN (2003) Estrogen receptors and distinct patterns of breast cancer relapse. Breast Cancer Res Treat 78(1):105–118

    Article  CAS  PubMed  Google Scholar 

  20. Smid M, Wang Y, Zhang Y, Sieuwerts AM, Yu J, Klijn JG, Foekens JA, Martens JW (2008) Subtypes of breast cancer show preferential site of relapse. Cancer Res 68(9):3108–3114. doi:10.1158/0008-5472.can-07-5644

    Article  CAS  PubMed  Google Scholar 

  21. Hartman AR, Kaldate RR, Sailer LM, Painter L, Grier CE, Endsley RR, Griffin M, Hamilton SA, Frye CA, Silberman MA, Wenstrup RJ, Sandbach JF (2012) Prevalence of BRCA mutations in an unselected population of triple-negative breast cancer. Cancer 118(11):2787–2795. doi:10.1002/cncr.26576

    Article  CAS  PubMed  Google Scholar 

  22. Gonzalez-Angulo AM, Timms KM, Liu S, Chen H, Litton JK, Potter J, Lanchbury JS, Stemke-Hale K, Hennessy BT, Arun BK, Hortobagyi GN, Do KA, Mills GB, Meric-Bernstam F (2011) Incidence and outcome of BRCA mutations in unselected patients with triple receptor-negative breast cancer. Clin Cancer Res 17(5):1082–1089. doi:10.1158/1078-0432.CCR-10-2560

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  23. Liebens FP, Carly B, Pastijn A, Rozenberg S (2007) Management of BRCA1/2 associated breast cancer: a systematic qualitative review of the state of knowledge in 2006. Eur J Cancer 43(2):238–257. doi:10.1016/j.ejca.2006.07.019

    Article  CAS  PubMed  Google Scholar 

  24. Morris EA, Liberman L, Ballon DJ, Robson M, Abramson AF, Heerdt A, Dershaw DD (2003) MRI of occult breast carcinoma in a high-risk population. AJR Am J Roentgenol 181(3):619–626. doi:10.2214/ajr.181.3.1810619

    Article  PubMed  Google Scholar 

  25. Brennan S, Liberman L, Dershaw DD, Morris E (2010) Breast MRI screening of women with a personal history of breast cancer. AJR Am J Roentgenol 195(2):510–516. doi:10.2214/ajr.09.3573

    Article  PubMed  Google Scholar 

  26. Gweon HM, Cho N, Han W, Yi A, Moon HG, Noh DY, Moon WK (2014) Breast MR imaging screening in women with a history of breast conservation therapy. Radiology 272(2):366–373. doi:10.1148/radiol.14131893

    Article  PubMed  Google Scholar 

  27. Pestalozzi BC, Zahrieh D, Price KN, Holmberg SB, Lindtner J, Collins J, Crivellari D, Fey MF, Murray E, Pagani O, Simoncini E, Castiglione-Gertsch M, Gelber RD, Coates AS, Goldhirsch A, International Breast Cancer Study G (2006) Identifying breast cancer patients at risk for central nervous system (CNS) metastases in trials of the International Breast Cancer Study Group (IBCSG). Ann Oncol 17(6):935–944. doi:10.1093/annonc/mdl064

    Article  CAS  PubMed  Google Scholar 

  28. Piccart-Gebhart MJ, Procter M, Leyland-Jones B, Goldhirsch A, Untch M, Smith I, Gianni L, Baselga J, Bell R, Jackisch C, Cameron D, Dowsett M, Barrios CH, Steger G, Huang CS, Andersson M, Inbar M, Lichinitser M, Lang I, Nitz U, Iwata H, Thomssen C, Lohrisch C, Suter TM, Ruschoff J, Suto T, Greatorex V, Ward C, Straehle C, McFadden E, Dolci MS, Gelber RD (2005) Trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer. N Engl J Med 353(16):1659–1672. doi:10.1056/NEJMoa052306

    Article  CAS  PubMed  Google Scholar 

  29. Romond EH, Perez EA, Bryant J, Suman VJ, Geyer CE Jr, Davidson NE, Tan-Chiu E, Martino S, Paik S, Kaufman PA, Swain SM, Pisansky TM, Fehrenbacher L, Kutteh LA, Vogel VG, Visscher DW, Yothers G, Jenkins RB, Brown AM, Dakhil SR, Mamounas EP, Lingle WL, Klein PM, Ingle JN, Wolmark N (2005) Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med 353(16):1673–1684. doi:10.1056/NEJMoa052122

    Article  CAS  PubMed  Google Scholar 

  30. Saphner T, Tormey DC, Gray R (1996) Annual hazard rates of recurrence for breast cancer after primary therapy. J Clin Oncol 14(10):2738–2746

    CAS  PubMed  Google Scholar 

  31. Pagani O, Price KN, Gelber RD, Castiglione-Gertsch M, Holmberg SB, Lindtner J, Thurlimann B, Collins J, Fey MF, Coates AS, Goldhirsch A (2009) Patterns of recurrence of early breast cancer according to estrogen receptor status: a therapeutic target for a quarter of a century. Breast Cancer Res Treat 117(2):319–324. doi:10.1007/s10549-008-0282-0

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  32. Peto R, Davies C, Godwin J, Gray R, Pan HC, Clarke M, Cutter D, Darby S, McGale P, Taylor C, Wang YC, Bergh J, Di Leo A, Albain K, Swain S, Piccart M, Pritchard K (2012) Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100,000 women in 123 randomised trials. Lancet 379(9814):432–444. doi:10.1016/s0140-6736(11)61625-5

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors have declared no conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Eunyoung Kang.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lee, Y., Kang, E., Lee, A.S. et al. Outcomes and recurrence patterns according to breast cancer subtypes in Korean women. Breast Cancer Res Treat 151, 183–190 (2015). https://doi.org/10.1007/s10549-015-3390-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-015-3390-7

Keywords

Navigation