Elisa Agostinetto1, Laura Giordano2, Rosalba Torrisi1, Rita De Sanctis3, Giovanna Masci1, Agnese Losurdo1, Monica Zuradelli1, Corrado Tinterri4, Wolfgang Gatzemeier4, Alberto Testori5, Marco Alloisio5, Fiorenza De Rose6, Bethania Fernandes7, Armando Santoro8. 1. Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano (Milan), Italy. 2. Biostatistic Unit, Humanitas Clinical and Research Center, Rozzano (Milan), Italy. 3. Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano (Milan), Italy; Department of Biomedical Sciences, Humanitas University, Rozzano (Milan), Italy. 4. Breast Unit, Humanitas Clinical and Research Center, Rozzano (Milan), Italy. 5. General and Thoracic Surgery, Humanitas Research Hospital, Rozzano (Milan), Italy. 6. Radiotherapy and Radiosurgery Department, Humanitas Clinical and Research Center, Rozzano (Milan), Italy. 7. Department of Pathology, Humanitas Clinical and Research Center, Rozzano (Milan), Italy. 8. Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center, Rozzano (Milan), Italy; Department of Biomedical Sciences, Humanitas University, Rozzano (Milan), Italy. Electronic address: armando.santoro@cancercenter.humanitas.it.
Abstract
BACKGROUND: Because the risk of relapse of node-negative breast cancer (BC) is varying, we evaluated the prognosis of patients with this disease and the factors associated with increased risk of relapse. PATIENTS AND METHODS: The clinical charts of patients with BC with evidence of negative nodes and with a potential ≥ 5-year follow-up were retrospectively reviewed. RESULTS: We analyzed 1276 patients. Over a median follow-up of 71.6 months (range, 1-227.2 months), we observed 159 events of relapse or death. The median RFS was 170 months. The median overall survival (OS) was 192 months. At univariate analysis, older age, negative hormonal receptors, larger tumor size and higher proliferation index (Ki67) were associated with worse recurrence-free survival (RFS) and OS (P < .05); higher grading was associated with worse RFS (P = .01). At multivariate analysis for RFS, age, Ki67 and tumor size confirmed their independent prognostic role. At multivariate analysis for OS, age and positive hormonal receptors showed an independent prognostic role. We observed no differences in prognosis between human epidermal growth factor receptor 2 (HER2) positive and triple-negative (TN) BC, but TNBC showed a worse OS compared with luminal-like BC. CONCLUSIONS: In node-negative BC, age, hormone receptor status, tumor size and Ki67 were prognostic factors. The TNBC subtype was not associated with poorer prognosis compared with the HER2-positive subtype, but showed a worse OS compared with luminal-like BC.
BACKGROUND: Because the risk of relapse of node-negative breast cancer (BC) is varying, we evaluated the prognosis of patients with this disease and the factors associated with increased risk of relapse. PATIENTS AND METHODS: The clinical charts of patients with BC with evidence of negative nodes and with a potential ≥ 5-year follow-up were retrospectively reviewed. RESULTS: We analyzed 1276 patients. Over a median follow-up of 71.6 months (range, 1-227.2 months), we observed 159 events of relapse or death. The median RFS was 170 months. The median overall survival (OS) was 192 months. At univariate analysis, older age, negative hormonal receptors, larger tumor size and higher proliferation index (Ki67) were associated with worse recurrence-free survival (RFS) and OS (P < .05); higher grading was associated with worse RFS (P = .01). At multivariate analysis for RFS, age, Ki67 and tumor size confirmed their independent prognostic role. At multivariate analysis for OS, age and positive hormonal receptors showed an independent prognostic role. We observed no differences in prognosis between humanepidermal growth factor receptor 2 (HER2) positive and triple-negative (TN) BC, but TNBC showed a worse OS compared with luminal-like BC. CONCLUSIONS: In node-negative BC, age, hormone receptor status, tumor size and Ki67 were prognostic factors. The TNBC subtype was not associated with poorer prognosis compared with the HER2-positive subtype, but showed a worse OS compared with luminal-like BC.