Takashi Hojo1, Norikazu Masuda2, Takayuki Iwamoto3, Naoki Niikura4, Keisei Anan5, Kenjiro Aogi6, Tatsuya Ohnishi7, Chisako Yamauchi7, Masayuki Yoshida8, Takayuki Kinoshita9, Hideji Masuoka10, Yasuaki Sagara11, Takashi Sakatani12, Yasuyuki Kojima13, Hitoshi Tsuda14, Hiraku Kumamaru15, Hiroaki Miyata16, Seigo Nakamura17. 1. Department of Breast Oncology, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan. tahojo@east.ncc.go.jp. 2. Department of Breast Surgery, Osaka National Hospital, 2-1-14, Houenzaka, Chuo-ku Osaka-shi, Osaka, 540-0006, Japan. 3. Department of Breast and Endocrine Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kitaku, Okayama City, Okayama, 700-8558, Japan. 4. Department of Breast and Endocrine Surgery, Tokai University School of Medicine, Kanagawa, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan. 5. Department of Surgery, Kitakyushu Municipal Medical Center, Kitakyushu, Japan. 6. Department of Breast Oncology, Shikoku Cancer Center, Matsuyama, Japan. 7. Department of Breast Surgery, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan. 8. Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. 9. Department of Breast Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. 10. Sapporo-kotoni Breast Clinic, Sapporo, Japan. 11. Department of Breast Surgery, Sagara Hospital, 3-31, Matsubara, Kagoshima, Kagoshima, 892-0833, Japan. 12. Department of Diagnostic Pathology, Nippon Medical School Hospital, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan. 13. Division of Breast and Endocrine Surgery, Department of Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae, Kawasaki, Kanagawa, 216-8511, Japan. 14. Department of Basic Pathology, National Defense Medical College, 3-2 Namiki, Tokorozawa, 359-8513, Japan. 15. Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. 16. Department of Health Policy and Management, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. 17. Division of Breast Surgical Oncology, Department of Surgery, Showa University, Tokyo, Japan.
Abstract
BACKGROUND: Adding taxane to an anthracycline-based regimen improves survival in node-positive breast cancer patients, as shown by clinical trials and meta-analyses. However, no studies have analyzed the number of metastatic lymph nodes in patients with estrogen receptor (ER)-positive cancer. This study investigated whether adding a taxane to an anthracycline-based regimen improved prognosis in node-positive, ER-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer patients in a real-world setting. METHODS: Using Japanese Breast Cancer Society registry data, we compared disease-free survival (DFS) of patients with ER-positive, HER2-negative breast cancer, excluding those receiving neoadjuvant chemotherapy, between those who received an anthracycline-based regimen followed by a taxane-based regimen (A + T) and those who received only an anthracycline-based regimen (A w/o T), stratified by lymph node status. A Cox proportional hazards model was used to evaluate DFS in both groups. RESULTS: There were 4566 eligible patients with ER-positive, HER2-negative breast cancer. During the median follow-up period of 60 months, there were 481 recurrences and 149 deaths. There was no significant difference in DFS between the A + T and A w/o T groups among patients with 1-3 positive nodes, while there was a significant difference among patients with ≥ 4 positive nodes. CONCLUSIONS: In patients with ER-positive, HER2-negative breast cancer, adding taxane to an anthracycline regimen did not improve DFS in patients with metastasis in 1-3 lymph nodes. We considered that the group without the addition of taxane might be present in patients with ER-positive, HER2-negative lymph node metastases.
BACKGROUND: Adding taxane to an anthracycline-based regimen improves survival in node-positive breast cancerpatients, as shown by clinical trials and meta-analyses. However, no studies have analyzed the number of metastatic lymph nodes in patients with estrogen receptor (ER)-positive cancer. This study investigated whether adding a taxane to an anthracycline-based regimen improved prognosis in node-positive, ER-positive, humanepidermal growth factor receptor 2 (HER2)-negative breast cancerpatients in a real-world setting. METHODS: Using Japanese Breast Cancer Society registry data, we compared disease-free survival (DFS) of patients with ER-positive, HER2-negative breast cancer, excluding those receiving neoadjuvant chemotherapy, between those who received an anthracycline-based regimen followed by a taxane-based regimen (A + T) and those who received only an anthracycline-based regimen (A w/o T), stratified by lymph node status. A Cox proportional hazards model was used to evaluate DFS in both groups. RESULTS: There were 4566 eligible patients with ER-positive, HER2-negative breast cancer. During the median follow-up period of 60 months, there were 481 recurrences and 149 deaths. There was no significant difference in DFS between the A + T and A w/o T groups among patients with 1-3 positive nodes, while there was a significant difference among patients with ≥ 4 positive nodes. CONCLUSIONS: In patients with ER-positive, HER2-negative breast cancer, adding taxane to an anthracycline regimen did not improve DFS in patients with metastasis in 1-3 lymph nodes. We considered that the group without the addition of taxane might be present in patients with ER-positive, HER2-negative lymph node metastases.
Authors: A D Seidman; L Norton; B S Reichman; J P Crown; T J Yao; R Heelan; T B Hakes; D E Lebwohl; T A Gilewski; A Surbone Journal: Semin Oncol Date: 1993-08 Impact factor: 4.929
Authors: Miguel Martín; Alvaro Rodríguez-Lescure; Amparo Ruiz; Emilio Alba; Lourdes Calvo; Manuel Ruiz-Borrego; Blanca Munárriz; César A Rodríguez; Carmen Crespo; Enrique de Alava; José Antonio López García-Asenjo; María Dolores Guitián; Sergio Almenar; Jesús Fernando González-Palacios; Francisco Vera; José Palacios; Manuel Ramos; Jose Manuel Gracia Marco; Ana Lluch; Isabel Alvarez; Miguel Angel Seguí; José Ignacio Mayordomo; Antonio Antón; José Manuel Baena; Arrate Plazaola; Alfonso Modolell; Amadeu Pelegrí; Jose Ramón Mel; Enrique Aranda; Encarna Adrover; José Valero Alvarez; José Luis García Puche; Pedro Sánchez-Rovira; Sonia Gonzalez; José Manuel López-Vega Journal: J Natl Cancer Inst Date: 2008-05-27 Impact factor: 13.506