Meng Lv1, Yan Mao2, Yuhua Song2, Yongmei Wang2, Xiaoyi Liu2, Xingang Wang2, Gang Nie2, Haibo Wang3. 1. Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China. Electronic address: lvmengstudy@163.com. 2. Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China. 3. Breast Disease Center, The Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, PR China. Electronic address: hbwang66@126.com.
Abstract
PURPOSE: To investigate the prognosis of single hormone receptor-positive (HR+) breast cancer (estrogen receptor [ER] positive and progesterone receptor [PR] negative, and ER-PR+) compared to double HR+ (ER+PR+) and double HR- (ER-PR-) tumors. METHODS: We included 531,605 cases of invasive breast cancer between 1990 and 2012 from the US Surveillance, Epidemiology, and End Results (SEER) database for study and classified cases into 4 phenotypes according to expression of ER and PR: ER+PR+, ER+PR-, ER-PR+, and ER-PR-. RESULTS: Overall, 66,091 ER+PR- tumors and 9320 ER-PR+ tumors were identified. The clinical characteristics of the ER+PR- group were similar to those of the double HR+ group, while those of the ER-PR+ and double HR- groups were similar. Overall survival of patients with single HR+ tumors was intermediate between that of double HR+ and double HR- tumors. However, we observed no differences in disease-specific survival between ER-PR+ and ER-PR- patients. In multivariate analysis, outcomes were similar. Relative to the double HR+ patient group, risk of death in the ER+PR- group was higher (hazard ratio, 1.422, 95% confidence interval, 1.394-1.452). However, risk of death was comparable between ER-PR+ and ER-PR- patients (hazard ratio, 1.03; 95% confidence interval, 0.98-1.08). Multivariate Cox proportional analysis showed that survival times of patients in the younger age bracket (< 60 years), those positive for human epidermal growth factor receptor 2 (HER2), and patients with tumor stage I-III were longer in the ER-PR+ group. CONCLUSION: Disease-specific survival of single HR+ tumor cases was longer than that of double HR- tumors but poorer than double HR+ tumors. However, differences in disease-specific survival were not significant between the ER-PR+ and ER-PR- groups.
PURPOSE: To investigate the prognosis of single hormone receptor-positive (HR+) breast cancer (estrogen receptor [ER] positive and progesterone receptor [PR] negative, and ER-PR+) compared to double HR+ (ER+PR+) and double HR- (ER-PR-) tumors. METHODS: We included 531,605 cases of invasive breast cancer between 1990 and 2012 from the US Surveillance, Epidemiology, and End Results (SEER) database for study and classified cases into 4 phenotypes according to expression of ER and PR: ER+PR+, ER+PR-, ER-PR+, and ER-PR-. RESULTS: Overall, 66,091 ER+PR- tumors and 9320 ER-PR+ tumors were identified. The clinical characteristics of the ER+PR- group were similar to those of the double HR+ group, while those of the ER-PR+ and double HR- groups were similar. Overall survival of patients with single HR+ tumors was intermediate between that of double HR+ and double HR- tumors. However, we observed no differences in disease-specific survival between ER-PR+ and ER-PR- patients. In multivariate analysis, outcomes were similar. Relative to the double HR+ patient group, risk of death in the ER+PR- group was higher (hazard ratio, 1.422, 95% confidence interval, 1.394-1.452). However, risk of death was comparable between ER-PR+ and ER-PR- patients (hazard ratio, 1.03; 95% confidence interval, 0.98-1.08). Multivariate Cox proportional analysis showed that survival times of patients in the younger age bracket (< 60 years), those positive for humanepidermal growth factor receptor 2 (HER2), and patients with tumor stage I-III were longer in the ER-PR+ group. CONCLUSION: Disease-specific survival of single HR+ tumor cases was longer than that of double HR- tumors but poorer than double HR+ tumors. However, differences in disease-specific survival were not significant between the ER-PR+ and ER-PR- groups.