Open AccessLong-term survival and stage I breast cancer subtypes
Author(s) -
Skye Hung-Chun Cheng,
Ben-Long Yu,
Cheng-Fang Horng,
Shih Chang Tsai,
ChiiMing Chen,
NaiShin Chu,
Mei-Hua Tsou,
Christopher Kwang-Jane Lin,
Li-Sun Shih,
Mei-Ching Liu
Publication year - 2016
Publication title -
journal of cancer research and practice
Language(s) - English
Resource type - Journals
eISSN - 2589-0425
pISSN - 2311-3006
DOI - 10.1016/j.jcrpr.2015.10.005
Subject(s) - medicine , breast cancer , oncology , hazard ratio , stage (stratigraphy) , proportional hazards model , confidence interval , triple negative breast cancer , cancer , hormone receptor , paleontology , biology
Background: This study is to evaluate the associations between long-term survival and stage I breast cancer by examining the hormonal receptor (HR) and human epidermal growth factor receptor-2 (HER2) status.Materials and methods: A total of 1595 breast cancer patients who were seen from 1990 to 2008 with surgery as first treatment and pathology stage I (T1N0) were included in this study. HR and HER2 status were used to approximate breast cancer subtypes. Additionally, ten-year relapse-free survival (RFS) rate and failure patterns of each subtype were evaluated. Multivariate analyses were performed in each subtype to identify the risk factors of recurrence.Results: Luminal-like (HR positive and HER2 negative) stage I patients showed a 10-year RFS rate of 89.5%, HER2 positive 92.9%, triple negative 91.1%, and unclassified subtype 86.2% (p = 0.089), respectively. The 10-year overall survival was 94.1% in luminal-like subtype, 90.1% in HER2, 94.5% in triple negative, and 85.3% in unclassified subtype. The independent recurrence risk factors in luminal-like subtype were ≤40 years of age (hazard ratio [HR] 2.2, 95% confidence interval [CI], 1.1–4.4), nuclear grade III (HR 2.7, CI, 1.4–5.3), and tumor >1.5 cm (HR 1.8, CI 1.0–3.4), and in unclassified subtype ≤40 years of age, tumor >1.5 cm, and adjuvant hormonal therapy. No risk factors were identified in HER2 or triple negative subtype.Conclusions: The factors associated with poor prognosis of stage I breast cancer vary by subtype. No risk factors were identified in HER2 subtype or triple negative patients. Tumor size >1.5 cm, age ≤40 years and nuclear grade 3 are the risk factors associated with poor prognosis in luminal-like subtype