Y Okumura1, R Nishimura1, K Nakatsukasa2, A Yoshida3, N Masuda4, M Tanabe5, T Shien6, S Tanaka7, N Arima8, Y Komoike9, T Taguchi2, T Iwase5, H Inaji9, M Ishitobi10. 1. Dept. of Breast & Endocrine Surgery, Kumamoto City Hospital, Kumamoto, Japan. 2. Dept. of Endocrine and Breast Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan. 3. Dept. of Breast Surgery, St. Luke's International Hospital, Tokyo, Japan. 4. Dept. of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan. 5. Division of Breast Oncology, The Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan. 6. Dept. of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan. 7. Section of Breast and Endocrine Surgery, Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan. 8. Dept. of Pathology, Kumamoto City Hospital, Kumamoto, Japan. 9. Dept. of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. 10. Dept. of Breast and Endocrine Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan. Electronic address: isitobi-ma@mc.pref.osaka.jp.
Abstract
INTRODUCTION: Changes in the biological marker status between primary and recurrent tumors are observed in breast cancer. However, their clinical significance is still uncertain, especially for patients with ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery. PATIENTS AND METHODS: A total of 117 patients with IBTR without distant metastases were enrolled in this study. All patients were examined for estrogen receptor (ER), HER2, and Ki-67 in both the primary tumors and paired IBTR. We evaluated the impact of changes in these biomarkers between primary tumors and IBTR on the prognosis after IBTR. RESULTS: There were no associations of changes in the ER, HER2 status with distant disease-free survival (DDFS) after surgical resection of IBTR, whereas the change in the Ki-67 status between the primary tumors and IBTR was significantly correlated with DDFS (unadjusted: p = 0.0094; adjusted: p = 0.013). Patients in the "increased or remained high" Ki-67 group had a significantly shorter DDFS than those in the "decreased or remained low" Ki-67 group (5-year DDFS: 55.5 vs. 79.3%, respectively, p = 0.0084 by log-rank test). CONCLUSION: An increased or persistently high Ki-67 status in the IBTR was significantly correlated with a poorer prognosis after IBTR.
INTRODUCTION: Changes in the biological marker status between primary and recurrent tumors are observed in breast cancer. However, their clinical significance is still uncertain, especially for patients with ipsilateral breast tumor recurrence (IBTR) after breast-conserving surgery. PATIENTS AND METHODS: A total of 117 patients with IBTR without distant metastases were enrolled in this study. All patients were examined for estrogen receptor (ER), HER2, and Ki-67 in both the primary tumors and paired IBTR. We evaluated the impact of changes in these biomarkers between primary tumors and IBTR on the prognosis after IBTR. RESULTS: There were no associations of changes in the ER, HER2 status with distant disease-free survival (DDFS) after surgical resection of IBTR, whereas the change in the Ki-67 status between the primary tumors and IBTR was significantly correlated with DDFS (unadjusted: p = 0.0094; adjusted: p = 0.013). Patients in the "increased or remained high" Ki-67 group had a significantly shorter DDFS than those in the "decreased or remained low" Ki-67 group (5-year DDFS: 55.5 vs. 79.3%, respectively, p = 0.0084 by log-rank test). CONCLUSION: An increased or persistently high Ki-67 status in the IBTR was significantly correlated with a poorer prognosis after IBTR.
Authors: Sebastian M Jud; Reinhard Hatko; Julius Emons; Bianca Lauterbach; Carolin C Hack; Caroline Preuß; Werner Adler; Matthias W Beckmann; Felix Heindl Journal: J Clin Med Date: 2020-12-13 Impact factor: 4.241