BACKGROUND: Prognosis and treatment options differ for each molecular subtype of breast cancer, but risk of regional lymph node (LN) metastasis for each subtype has not been well studied. Since LN status is the most important predictor for prognosis, the aim of this study is to investigate the propensity for LN metastasis in each of the five breast cancer molecular subtypes. METHODS: Under an institutional review board-approved protocol, we retrospectively reviewed the charts of all pathologically confirmed breast cancer cases from January 2004 to June 2012. Five subtypes were defined as luminal A (hormone receptor positive, Ki-67 low), luminal B (hormone receptor positive, Ki-67 high), luminal human epidermal growth factor receptor 2 (HER2), HER2-enriched (hormone receptor negative), and triple negative (TN). RESULTS: A total of 375 patients with complete data were classified by subtype: 95 (25.3%) luminal A, 120 (32%) luminal B, 69 (18.4%) luminal HER2, 26 (6.9%) HER2-enriched, and 65 (17.3%) TN. On univariate analysis, age (<50), higher tumor grade, HER2+ status, tumor size, and molecular subtype were significant for LN positivity. Molecular subtype correlated strongly with tumor size (χ(2); P = 0.0004); therefore, multivariable logistic regression did not identify molecular subtype as an independent variable to predict LN positivity. CONCLUSIONS: Luminal A tumors have the lowest risk of LN metastasis, whereas luminal HER2 subtype has the highest risk of LN metastasis. Immunohistochemical-based molecular classification can be readily performed and knowledge of the factors that affect LN status may help with treatment decisions.
BACKGROUND: Prognosis and treatment options differ for each molecular subtype of breast cancer, but risk of regional lymph node (LN) metastasis for each subtype has not been well studied. Since LN status is the most important predictor for prognosis, the aim of this study is to investigate the propensity for LN metastasis in each of the five breast cancer molecular subtypes. METHODS: Under an institutional review board-approved protocol, we retrospectively reviewed the charts of all pathologically confirmed breast cancer cases from January 2004 to June 2012. Five subtypes were defined as luminal A (hormone receptor positive, Ki-67 low), luminal B (hormone receptor positive, Ki-67 high), luminal humanepidermal growth factor receptor 2 (HER2), HER2-enriched (hormone receptor negative), and triple negative (TN). RESULTS: A total of 375 patients with complete data were classified by subtype: 95 (25.3%) luminal A, 120 (32%) luminal B, 69 (18.4%) luminal HER2, 26 (6.9%) HER2-enriched, and 65 (17.3%) TN. On univariate analysis, age (<50), higher tumor grade, HER2+ status, tumor size, and molecular subtype were significant for LN positivity. Molecular subtype correlated strongly with tumor size (χ(2); P = 0.0004); therefore, multivariable logistic regression did not identify molecular subtype as an independent variable to predict LN positivity. CONCLUSIONS: Luminal A tumors have the lowest risk of LN metastasis, whereas luminal HER2 subtype has the highest risk of LN metastasis. Immunohistochemical-based molecular classification can be readily performed and knowledge of the factors that affect LN status may help with treatment decisions.
Authors: Roman Rouzier; Charles M Perou; W Fraser Symmans; Nuhad Ibrahim; Massimo Cristofanilli; Keith Anderson; Kenneth R Hess; James Stec; Mark Ayers; Peter Wagner; Paolo Morandi; Chang Fan; Islam Rabiul; Jeffrey S Ross; Gabriel N Hortobagyi; Lajos Pusztai Journal: Clin Cancer Res Date: 2005-08-15 Impact factor: 12.531
Authors: Lisa A Carey; Charles M Perou; Chad A Livasy; Lynn G Dressler; David Cowan; Kathleen Conway; Gamze Karaca; Melissa A Troester; Chiu Kit Tse; Sharon Edmiston; Sandra L Deming; Joseph Geradts; Maggie C U Cheang; Torsten O Nielsen; Patricia G Moorman; H Shelton Earp; Robert C Millikan Journal: JAMA Date: 2006-06-07 Impact factor: 56.272
Authors: T Sørlie; C M Perou; R Tibshirani; T Aas; S Geisler; H Johnsen; T Hastie; M B Eisen; M van de Rijn; S S Jeffrey; T Thorsen; H Quist; J C Matese; P O Brown; D Botstein; P E Lønning; A L Børresen-Dale Journal: Proc Natl Acad Sci U S A Date: 2001-09-11 Impact factor: 11.205
Authors: C M Perou; T Sørlie; M B Eisen; M van de Rijn; S S Jeffrey; C A Rees; J R Pollack; D T Ross; H Johnsen; L A Akslen; O Fluge; A Pergamenschikov; C Williams; S X Zhu; P E Lønning; A L Børresen-Dale; P O Brown; D Botstein Journal: Nature Date: 2000-08-17 Impact factor: 49.962
Authors: Torsten O Nielsen; Forrest D Hsu; Kristin Jensen; Maggie Cheang; Gamze Karaca; Zhiyuan Hu; Tina Hernandez-Boussard; Chad Livasy; Dave Cowan; Lynn Dressler; Lars A Akslen; Joseph Ragaz; Allen M Gown; C Blake Gilks; Matt van de Rijn; Charles M Perou Journal: Clin Cancer Res Date: 2004-08-15 Impact factor: 12.531
Authors: Therese Sorlie; Robert Tibshirani; Joel Parker; Trevor Hastie; J S Marron; Andrew Nobel; Shibing Deng; Hilde Johnsen; Robert Pesich; Stephanie Geisler; Janos Demeter; Charles M Perou; Per E Lønning; Patrick O Brown; Anne-Lise Børresen-Dale; David Botstein Journal: Proc Natl Acad Sci U S A Date: 2003-06-26 Impact factor: 12.779
Authors: Antonio Martínez-Aranda; Vanessa Hernández; Ferran Moreno; Núria Baixeras; Daniel Cuadras; Ander Urruticoechea; Miguel Gil-Gil; Noemí Vidal; Xavier Andreu; Miquel A Seguí; Rosa Ballester; Eva Castella; Angels Sierra Journal: Front Oncol Date: 2017-12-01 Impact factor: 6.244
Authors: G Houvenaeghel; R Sabatier; F Reyal; J M Classe; S Giard; H Charitansky; R Rouzier; C Faure; J R Garbay; E Daraï; D Hudry; P Gimbergues; R Villet; E Lambaudie Journal: Br J Cancer Date: 2016-09-29 Impact factor: 7.640