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Clinicopathological factors predicting early and late distant recurrence in estrogen receptor-positive, HER2-negative breast cancer

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Abstract

Background

Most studies analyzing prognostic factors for late relapse have been performed in postmenopausal women who received tamoxifen or aromatase inhibitors as adjuvant endocrine therapy for estrogen receptor (ER)-positive breast cancer.

Methods

A total of 223 patients (108 premenopausal and 115 postmenopausal) with early distant recurrence and 149 patients (62 premenopausal and 87 postmenopausal) with late distant recurrence of ER-positive, HER2-negative breast cancer who were given their initial treatment between 2000 and 2004 were registered from nine institutions. For each late recurrence patient, approximately two matched control patients without relapse for more than 10 years were selected. Clinicopathological factors and adjuvant therapies were compared among the three groups by menopausal status and age.

Results

Factors predicting early recurrence in premenopausal women were large tumor size, high lymph node category and high tumor grade, whereas predictors for late recurrence were large tumor size and high lymph node category. In postmenopausal women under 60 years of age, factors predicting early recurrence were bilateral breast cancer, large tumor size, high lymph node category, low PgR expression and high Ki67 labeling index (LI), while predictors for late recurrence were large tumor size and high lymph node category. On the other hand, in postmenopausal women aged 60 years or older, factors predicting early recurrence were bilateral breast cancer, large tumor size, high lymph node category, high tumor grade, low ER expression and high Ki67 LI, whereas predictors for late recurrence were high lymph node category, low ER expression and short duration of adjuvant endocrine therapy.

Conclusion

Predictors of early and late distant recurrence might differ according to menopausal status and age.

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Abbreviations

ER:

Estrogen receptor

PgR:

Progesterone receptor

HER2:

Human epidermal growth factor receptor type 2

Ki67 LI:

Ki67 labeling index

IHC:

Immunohistochemistry

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Acknowledgments

This study was supported by Grant-in-Aid for Scientific Research from the Japanese Breast Cancer Society.

Author information

Author notes

  1. Tomofumi Osako

    Present address: Kumamoto Shinto General Hospital, Kumamoto, Japan

Authors and Affiliations

  1. Breast Surgery, Hokkaido University Hospital, Kita 14, Nishi 5, Kita-ku, Sapporo, 060-8648, Japan

    Hiroko Yamashita, Mitsuchika Hosoda & Naoko Ishida

  2. Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

    Akiko Ogiya & Kieko Yamazaki

  3. Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan

    Tadahiko Shien & Yuichiro Miyoshi

  4. Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan

    Yoshiya Horimoto

  5. Department of Surgery, Breast oncology, NHO Osaka National Hospital, Osaka, Japan

    Norikazu Masuda & Hiroyuki Yasojima

  6. Department of Breast and Endocrine Surgery, Graduate School of Medical Science, Kumamoto University, Kumamoto, Japan

    Touko Inao

  7. Department of Breast and Endocrine Surgery, Kumamoto City Hospital, Kumamoto, Japan

    Tomofumi Osako

  8. Department of Breast Surgery, NHO Hokkaido Cancer Center, Sapporo, Japan

    Masato Takahashi & Nobumoto Tomioka

  9. Department of Oncology, Immunology and Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan

    Yumi Endo

  10. Division of Pathology, Cancer Institute of the Japanese Foundation for Cancer Research, Tokyo, Japan

    Rie Horii

Authors
  1. Hiroko Yamashita
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  2. Akiko Ogiya
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  9. Yumi Endo
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  16. Nobumoto Tomioka
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Consortia

Collaborative Study Group of Scientific Research of the Japanese Breast Cancer Society

Corresponding author

Correspondence to Hiroko Yamashita.

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The authors have no conflict of interest.

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Yamashita, H., Ogiya, A., Shien, T. et al. Clinicopathological factors predicting early and late distant recurrence in estrogen receptor-positive, HER2-negative breast cancer. Breast Cancer 23, 830–843 (2016). https://doi.org/10.1007/s12282-015-0649-0

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  • DOI: https://doi.org/10.1007/s12282-015-0649-0

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