Judy C Boughey1, Karla V Ballman, Linda M McCall, Elizabeth A Mittendorf, William Fraser Symmans, Thomas B Julian, David Byrd, Kelly K Hunt. 1. *Mayo Clinic, Rochester, MN †Alliance Statistics and Data Center, Weill Medical College of Cornell University, New York, NY ‡Alliance Statistics and Data Center, Duke University, Durham, NC §The University of Texas MD Anderson Cancer Center, Houston, TX ¶NRG Oncology and The Allegheny Health Network, Pittsburgh, PA ||SWOG and University of Washington Medical Center, Seattle, WA.
Abstract
BACKGROUND: Women with node-positive breast cancer are at high risk for recurrence. We evaluate the impact of approximated tumor subtype and response to chemotherapy on long-term outcomes in a node-positive cohort receiving neoadjuvant chemotherapy. METHODS: ACOSOG Z1071 enrolled cT0-4N1-2 breast cancer patients treated with neoadjuvant chemotherapy from 2009 to 2011. Factors impacting breast cancer-specific survival (BCSS) and overall survival (OS) were analyzed. RESULTS: Median follow-up of 701 eligible patients was 4.1 years (0.4-6.5). Ninety patients (12.8%) died from breast cancer. Approximated subtype and chemotherapy response were significantly associated with BCSS and OS (P < 0.0001). BCSS and OS were highest in patients who achieved pathologic complete response (pCR) (P < 0.0001 and P < 0.0001, respectively).Five-year BCSS was highest in human epidermal growth factor receptor 2 (HER2)-positive disease [95.8%; 95% confidence interval (CI): 87.7-98.6], followed by hormone receptor-positive/HER2-negative (80.4%; 95% CI: 73.2-85.9) and lowest in triple-negative (TNBC) (74.8%; 95% CI: 66.6-81.2; P < 0.0001). Similar patterns were seen in OS.In TNBC (n = 174), 5-year BCSS was higher in patients with pCR versus residual disease (89.8%; 95% CI: 78.8-95.3 vs 65.8%; 95% CI: 54.5-74.9; P = 0.0013). In hormone receptor-positive/HER2-negative (n = 318) disease, BCSS was 100% in patients with pCR and 78.3% (95% CI: 70.4-84.3) in those with residual disease (P = 0.018). In HER2-positive disease (n = 204) there was no difference between pCR and residual disease (96.0%; 95% CI: 83.6-99.1 vs 95.8%; 95% CI: 81.4-99.1; P = 0.77). CONCLUSIONS: In node-positive breast cancer patients treated with neoadjuvant chemotherapy, BCSS and OS were associated with approximated subtype and chemotherapy response and were lowest in TNBC patients with residual disease. Five-year BCSS was > 95% in HER2-positive disease independent of chemotherapy response.
BACKGROUND:Women with node-positive breast cancer are at high risk for recurrence. We evaluate the impact of approximated tumor subtype and response to chemotherapy on long-term outcomes in a node-positive cohort receiving neoadjuvant chemotherapy. METHODS: ACOSOG Z1071 enrolled cT0-4N1-2 breast cancerpatients treated with neoadjuvant chemotherapy from 2009 to 2011. Factors impacting breast cancer-specific survival (BCSS) and overall survival (OS) were analyzed. RESULTS: Median follow-up of 701 eligible patients was 4.1 years (0.4-6.5). Ninety patients (12.8%) died from breast cancer. Approximated subtype and chemotherapy response were significantly associated with BCSS and OS (P < 0.0001). BCSS and OS were highest in patients who achieved pathologic complete response (pCR) (P < 0.0001 and P < 0.0001, respectively).Five-year BCSS was highest in humanepidermal growth factor receptor 2 (HER2)-positive disease [95.8%; 95% confidence interval (CI): 87.7-98.6], followed by hormone receptor-positive/HER2-negative (80.4%; 95% CI: 73.2-85.9) and lowest in triple-negative (TNBC) (74.8%; 95% CI: 66.6-81.2; P < 0.0001). Similar patterns were seen in OS.In TNBC (n = 174), 5-year BCSS was higher in patients with pCR versus residual disease (89.8%; 95% CI: 78.8-95.3 vs 65.8%; 95% CI: 54.5-74.9; P = 0.0013). In hormone receptor-positive/HER2-negative (n = 318) disease, BCSS was 100% in patients with pCR and 78.3% (95% CI: 70.4-84.3) in those with residual disease (P = 0.018). In HER2-positive disease (n = 204) there was no difference between pCR and residual disease (96.0%; 95% CI: 83.6-99.1 vs 95.8%; 95% CI: 81.4-99.1; P = 0.77). CONCLUSIONS: In node-positive breast cancerpatients treated with neoadjuvant chemotherapy, BCSS and OS were associated with approximated subtype and chemotherapy response and were lowest in TNBCpatients with residual disease. Five-year BCSS was > 95% in HER2-positive disease independent of chemotherapy response.
Authors: Aman U Buzdar; Vicente Valero; Nuhad K Ibrahim; Deborah Francis; Kristine R Broglio; Richard L Theriault; Lajos Pusztai; Marjorie C Green; Sonja E Singletary; Kelly K Hunt; Aysegul A Sahin; Francisco Esteva; William F Symmans; Michael S Ewer; Thomas A Buchholz; Gabriel N Hortobagyi Journal: Clin Cancer Res Date: 2007-01-01 Impact factor: 12.531
Authors: W Fraser Symmans; Caimiao Wei; Rebekah Gould; Xian Yu; Ya Zhang; Mei Liu; Andrew Walls; Alex Bousamra; Maheshwari Ramineni; Bruno Sinn; Kelly Hunt; Thomas A Buchholz; Vicente Valero; Aman U Buzdar; Wei Yang; Abenaa M Brewster; Stacy Moulder; Lajos Pusztai; Christos Hatzis; Gabriel N Hortobagyi Journal: J Clin Oncol Date: 2017-01-30 Impact factor: 44.544
Authors: Judy C Boughey; Florentia Peintinger; Funda Meric-Bernstam; Allison C Perry; Kelly K Hunt; Gildy V Babiera; S E Singletary; Isabelle Bedrosian; Anthony Lucci; Aman U Buzdar; Lajos Pusztai; Henry M Kuerer Journal: Ann Surg Date: 2006-09 Impact factor: 12.969
Authors: Elena Provenzano; Veerle Bossuyt; Giuseppe Viale; David Cameron; Sunil Badve; Carsten Denkert; Gaëtan MacGrogan; Frédérique Penault-Llorca; Judy Boughey; Giuseppe Curigliano; J Michael Dixon; Laura Esserman; Gerd Fastner; Thorsten Kuehn; Florentia Peintinger; Gunter von Minckwitz; Julia White; Wei Yang; W Fraser Symmans Journal: Mod Pathol Date: 2015-07-24 Impact factor: 7.842
Authors: W Fraser Symmans; Florentia Peintinger; Christos Hatzis; Radhika Rajan; Henry Kuerer; Vicente Valero; Lina Assad; Anna Poniecka; Bryan Hennessy; Marjorie Green; Aman U Buzdar; S Eva Singletary; Gabriel N Hortobagyi; Lajos Pusztai Journal: J Clin Oncol Date: 2007-09-04 Impact factor: 44.544
Authors: Judy C Boughey; Vera J Suman; Elizabeth A Mittendorf; Gretchen M Ahrendt; Lee G Wilke; Bret Taback; A Marilyn Leitch; Henry M Kuerer; Monet Bowling; Teresa S Flippo-Morton; David R Byrd; David W Ollila; Thomas B Julian; Sarah A McLaughlin; Linda McCall; W Fraser Symmans; Huong T Le-Petross; Bruce G Haffty; Thomas A Buchholz; Heidi Nelson; Kelly K Hunt Journal: JAMA Date: 2013-10-09 Impact factor: 56.272
Authors: M M Kim; P Allen; A M Gonzalez-Angulo; W A Woodward; F Meric-Bernstam; A U Buzdar; K K Hunt; H M Kuerer; J K Litton; G N Hortobagyi; T A Buchholz; E A Mittendorf Journal: Ann Oncol Date: 2013-04-05 Impact factor: 32.976
Authors: Prema P Peethambaram; Tanya L Hoskin; Courtney N Day; Matthew P Goetz; Elizabeth B Habermann; Judy C Boughey Journal: NPJ Breast Cancer Date: 2017-10-19
Authors: Giacomo Montagna; Minna K Lee; Varadan Sevilimedu; Andrea V Barrio; Monica Morrow Journal: Ann Surg Oncol Date: 2022-07-28 Impact factor: 4.339
Authors: Abigail S Caudle; Henry M Kuerer; Savitri Krishnamurthy; Kyungmin Shin; Brian P Hobbs; Junsheng Ma; Elizabeth A Mittendorf; Ashley C Washington; Sarah M DeSnyder; Dalliah M Black; Kelly K Hunt; Wei T Yang Journal: Cancer Date: 2018-10-25 Impact factor: 6.860
Authors: T J Stankowski-Drengler; J R Schumacher; B Hanlon; D Livingston-Rosanoff; K Van de Walle; C C Greenberg; L G Wilke; H B Neuman Journal: Ann Surg Oncol Date: 2020-01-03 Impact factor: 5.344
Authors: Elena Laakmann; Isabell Witzel; Peter A Fasching; Mahdi Rezai; Christian Schem; Christine Solbach; Hans Tesch; Peter Klare; Andreas Schneeweiss; Christoph Salat; Dirk-Michael Zahm; Jens-Uwe Blohmer; Barbara Ingold-Heppner; Jens Huober; Claus Hanusch; Christian Jackisch; Mattea Reinisch; Michael Untch; Gunter von Minckwitz; Valentina Nekljudova; Volkmar Müller; Sibylle Loibl Journal: Breast Cancer Res Date: 2019-05-10 Impact factor: 6.466