Impact of molecular subtype on locoregional recurrence in mastectomy patients with T1-T2 breast cancer and 1-3 positive lymph nodes Journal Article
| Authors: | Moo, T. A.; McMillan, R.; Lee, M.; Stempel, M.; Ho, A.; Patil, S.; El-Tamer, M. |
| Article Title: | Impact of molecular subtype on locoregional recurrence in mastectomy patients with T1-T2 breast cancer and 1-3 positive lymph nodes |
| Abstract: | Background: Postmastectomy radiation (PMRT) in T1-T2 tumors with 1-3 positive axillary lymph nodes (ALNs) is controversial. Impact of molecular subtype (MST) on locoregional recurrence (LRR) and PMRT benefit is uncertain. We examined the association between MST and LRR, recurrence-free survival (RFS), and overall survival (OS), in T1-T2 tumors with 1-3 positive ALNs. Methods: From an institutional database, we identified mastectomy patients with 1-3 positive ALNs between 1995 and 2006. Patients who received neoadjuvant chemotherapy, had T3-T4 tumors, or ≥4 positive ALNs were excluded. MST was defined as: hormone receptor (HR)+/HER2-(luminal A/B), HR+/HER2+(luminal HER2), HR-/HER2+(HER2), and HR-/HER2-(basal). Kaplan-Meier method and Cox regression analysis were used to examine association between MST and LRR, RFS, and OS. Results: This study included 884 patients (700 no PMRT, 141 PMRT): 72.8 % luminal A/B, 7.8 % luminal HER2, 6.8 % HER2, and 12.6 % basal. Median follow-up was 6.3 years; 39 LRRs occurred. Luminal A/B subtype had the smallest tumors (p = 0.03), lowest intraductal component (p = 0.01), histologic grade (p < 0.0001), lymphovascular invasion (LVI) (p = 0.008), and multifocality/multicentricity (p = 0.02). On univariate analyses, there was no association between MST and LRR. MST was associated with RFS and OS; the basal and HER2 subtype had the lowest RFS (p = 0.0002) and OS (p < 0.0001). On multivariate analysis, only age ≤50 years (p = 0.003) and presence of LVI (p = 0.0003) were predictive of LRR; MST was not (p = 0.38). Conclusion: In patients with T1-T2 breast cancer and 1-3 positive lymph nodes who did not receive PMRT, MST was not an independent predictor of LRR and may not be useful in selecting PMRT candidates in that group. © 2014 Society of Surgical Oncology. Reference:. |
| Keywords: | adult; cancer survival; controlled study; major clinical study; overall survival; histopathology; cancer recurrence; cancer radiotherapy; cancer staging; follow up; lymph node dissection; disease association; breast cancer; mastectomy; epidermal growth factor receptor 2; cancer hormone therapy; axillary lymph node; proportional hazards model; adjuvant chemotherapy; kaplan meier method; taxane derivative; trastuzumab; anthracycline; hormone receptor; recurrence free survival; postmastectomy radiation; radiological parameters; locoregional recurrence; cancer prognosis; lymph vessel metastasis; human; female; article |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 21 |
| Issue: | 5 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2014-05-01 |
| Start Page: | 1569 |
| End Page: | 1574 |
| Language: | English |
| DOI: | 10.1245/s10434-014-3488-x |
| PROVIDER: | scopus |
| PUBMED: | 24488216 |
| PMCID: | PMC4366059 |
| DOI/URL: | |
| Notes: | Ann. Surg. Oncol. -- Export Date: 2 June 2014 -- CODEN: ASONF -- Source: Scopus |
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