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Unexpected features of breast cancer subtype.

Liu YH, Wang OC, Chen ED, Cai YF, Pan CM, Yang F, Zhang XH - World J Surg Oncol (2015)

Bottom Line: On univariate analysis, the LN positivity varied across subtypes with 33.6% in luminal A, 40.3% in luminalHer2-, 37.3% in luminalHer2+, 37.6% in TNBC, and 47.4 % in HER-2+ (p=0.201).There was no significant difference in LN positivity among subtypes.Even though breast cancer subtype is not a statistically significant predictor of LN positivity, this information may still be useful in selecting the appropriate therapy in clinical practice.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, South of Bai-xiang Street, Ou-hai District, 325000, Wenzhou, Zhejiang, People's Republic of China. 1259932365@qq.com.

ABSTRACT

Background: Gene expression profiling of breast cancers identifies distinct molecular subtypes that affect prognosis. The aim of this study was to determine whether features of tumors especially the risks of lymph node (LN) metastases differ among molecular subtypes.

Methods: Subtypes were classified by immunohistochemical surrogates as luminal A, luminalHer2-, luminalHer2+, TNBC, and HER-2+. Data were obtained from an established, registered database of patients with invasive breast cancer treated at our hospital between July 2012 and October 2014. A total of 929 tumors were classifiable into molecular subtypes.

Results: The distribution of subtypes was luminal A (24.2%), luminalHer2- (27.8%), luminalHer2+ (9.1%), TNBC (21.3%), and HER-2+ (17.5%). Marked differences in age, tumor size, extent of lymph node involvement, and grade were observed among subtypes. On univariate analysis, the LN positivity varied across subtypes with 33.6% in luminal A, 40.3% in luminalHer2-, 37.3% in luminalHer2+, 37.6% in TNBC, and 47.4 % in HER-2+ (p=0.201). There was no significant difference in LN positivity among subtypes. On multivariable analysis, grade and tumor size were independent predictors of LN positivity.

Conclusions: Predictors of LN metastases include higher grade and larger tumor size. Even though breast cancer subtype is not a statistically significant predictor of LN positivity, this information may still be useful in selecting the appropriate therapy in clinical practice.

No MeSH data available.


Related in: MedlinePlus

Number of total positive LN by subtype (p = 0.201). N0 vs. N1 vs. N2. More N0 in luminal A/TNBC, more N2 in luminalHer−, luminalHer+, and Her-2+
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Fig1: Number of total positive LN by subtype (p = 0.201). N0 vs. N1 vs. N2. More N0 in luminal A/TNBC, more N2 in luminalHer−, luminalHer+, and Her-2+

Mentions: A total of 929 patients met the study criteria. Of these, 100 underwent breast-conserving surgery (BCS) and 829 were treated with mastectomy. The mean patient age was 52 (range, 25–90) years. Luminal A tumors were present in 24.2 %, luminalHer2− in 27.8 %, luminalHer2+ in 9.1 %, TNBC in 21.3 %, and HER-2+ in 17.5 %. Patient and tumor characteristics by subtype are summarized in Table 1. Among the four breast cancer subtypes, there were significant differences in the distribution of tumor size (all p = 0.002) and grade (all p < 0.0001). Luminal A tumors were smaller when compared to luminalHer2−, luminalHer2+, TNBC, and HER-2+ tumors (2.0 vs. 2.3, 2.3, 2.4, and 2.5; p = 0.001). Tumors overexpressing HER-2 (luminalHer2+ and HER-2+) and TNBC subtypes were more frequently in grade 3 and T3. HER-2+ tumors were more likely to have involvement of nodes. LN metastases were detected in 343 (39.1 %) patients. The LN positivity rate varied across subtypes with 73 of 217 (33.6 %) patients in luminal A, 96 of 238 (40.3 %) in luminalHer2−, 31 of 83 (37.3 %) in luminalHer2+, 70 of 186 (37.6 %) in TNBC, and 73 of 154 (47.4 %) in HER-2+. In addition, luminal A breast cancers were more frequently node-negative when compared to the others (66.4 vs. 59.7, 62.7, 62.4, and 52.6 %, respectively) and less frequently had four or more positive nodes (11.5 vs. 18.1,19.3,16.7 and 22.1 %, respectively) (Fig. 1). However, on univariate analysis, these data suggest that there was no significant difference in the incidence of nodal metastases among the four breast cancer subtypes (p = 0.201).Table 1


Unexpected features of breast cancer subtype.

Liu YH, Wang OC, Chen ED, Cai YF, Pan CM, Yang F, Zhang XH - World J Surg Oncol (2015)

Number of total positive LN by subtype (p = 0.201). N0 vs. N1 vs. N2. More N0 in luminal A/TNBC, more N2 in luminalHer−, luminalHer+, and Her-2+
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4536700&req=5

Fig1: Number of total positive LN by subtype (p = 0.201). N0 vs. N1 vs. N2. More N0 in luminal A/TNBC, more N2 in luminalHer−, luminalHer+, and Her-2+
Mentions: A total of 929 patients met the study criteria. Of these, 100 underwent breast-conserving surgery (BCS) and 829 were treated with mastectomy. The mean patient age was 52 (range, 25–90) years. Luminal A tumors were present in 24.2 %, luminalHer2− in 27.8 %, luminalHer2+ in 9.1 %, TNBC in 21.3 %, and HER-2+ in 17.5 %. Patient and tumor characteristics by subtype are summarized in Table 1. Among the four breast cancer subtypes, there were significant differences in the distribution of tumor size (all p = 0.002) and grade (all p < 0.0001). Luminal A tumors were smaller when compared to luminalHer2−, luminalHer2+, TNBC, and HER-2+ tumors (2.0 vs. 2.3, 2.3, 2.4, and 2.5; p = 0.001). Tumors overexpressing HER-2 (luminalHer2+ and HER-2+) and TNBC subtypes were more frequently in grade 3 and T3. HER-2+ tumors were more likely to have involvement of nodes. LN metastases were detected in 343 (39.1 %) patients. The LN positivity rate varied across subtypes with 73 of 217 (33.6 %) patients in luminal A, 96 of 238 (40.3 %) in luminalHer2−, 31 of 83 (37.3 %) in luminalHer2+, 70 of 186 (37.6 %) in TNBC, and 73 of 154 (47.4 %) in HER-2+. In addition, luminal A breast cancers were more frequently node-negative when compared to the others (66.4 vs. 59.7, 62.7, 62.4, and 52.6 %, respectively) and less frequently had four or more positive nodes (11.5 vs. 18.1,19.3,16.7 and 22.1 %, respectively) (Fig. 1). However, on univariate analysis, these data suggest that there was no significant difference in the incidence of nodal metastases among the four breast cancer subtypes (p = 0.201).Table 1

Bottom Line: On univariate analysis, the LN positivity varied across subtypes with 33.6% in luminal A, 40.3% in luminalHer2-, 37.3% in luminalHer2+, 37.6% in TNBC, and 47.4 % in HER-2+ (p=0.201).There was no significant difference in LN positivity among subtypes.Even though breast cancer subtype is not a statistically significant predictor of LN positivity, this information may still be useful in selecting the appropriate therapy in clinical practice.

View Article: PubMed Central - PubMed

Affiliation: Department of Oncology, The First Affiliated Hospital of Wenzhou Medical University, South of Bai-xiang Street, Ou-hai District, 325000, Wenzhou, Zhejiang, People's Republic of China. 1259932365@qq.com.

ABSTRACT

Background: Gene expression profiling of breast cancers identifies distinct molecular subtypes that affect prognosis. The aim of this study was to determine whether features of tumors especially the risks of lymph node (LN) metastases differ among molecular subtypes.

Methods: Subtypes were classified by immunohistochemical surrogates as luminal A, luminalHer2-, luminalHer2+, TNBC, and HER-2+. Data were obtained from an established, registered database of patients with invasive breast cancer treated at our hospital between July 2012 and October 2014. A total of 929 tumors were classifiable into molecular subtypes.

Results: The distribution of subtypes was luminal A (24.2%), luminalHer2- (27.8%), luminalHer2+ (9.1%), TNBC (21.3%), and HER-2+ (17.5%). Marked differences in age, tumor size, extent of lymph node involvement, and grade were observed among subtypes. On univariate analysis, the LN positivity varied across subtypes with 33.6% in luminal A, 40.3% in luminalHer2-, 37.3% in luminalHer2+, 37.6% in TNBC, and 47.4 % in HER-2+ (p=0.201). There was no significant difference in LN positivity among subtypes. On multivariable analysis, grade and tumor size were independent predictors of LN positivity.

Conclusions: Predictors of LN metastases include higher grade and larger tumor size. Even though breast cancer subtype is not a statistically significant predictor of LN positivity, this information may still be useful in selecting the appropriate therapy in clinical practice.

No MeSH data available.


Related in: MedlinePlus