Lingmi Hou1,2, Mengxue Qiu3, Maoshan Chen3,4, Fangfang Li4, Junyan Li5, Shishan Deng1, Yahan Yang6, Zhenggui Du3, Hongwei Yang4. 1. Department of Breast and Thyroid Surgery, Biological Targeting Laboratory of Breast Cancer, Academician (expert) Workstation, Affiliated Hospital of North Sichuan Medical College, Nanchong, China. 2. Yingshan Hospital of West China Hospital, Sichuan University, Nangchong, China. 3. Department of Breast Surgery, West China Hospital, Sichuan University, Chengdu, China. 4. Department of Breast and Thyroid Surgery, Affiliated Suining Central Hospital of Chongqing Medical University, Suining, China. 5. Department of Breast Surgery, People's Hospital of Deyang City, Deyang, China. 6. Clinical Medicine, Queen Mary College of Nanchang University, Nanchang, China.
Abstract
BACKGROUND: Molecular subtype, the basis for personalized treatment of breast cancer, is of great value in evaluating prognosis and guiding treatment of early-stage breast cancer. However, its value in stage IV patients remains unclear. In this study, we investigated the association between molecular subtype and prognosis of de novo stage IV breast cancer using Surveillance, Epidemiology, and End Results (SEER) database with the purpose to provide evidence for optimal therapeutic options for breast cancer patients. METHODS: We retrospectively analyzed de novo stage IV breast cancer patients with the SEER Program data from 2010 to 2015. Characteristics of patients with different molecular subtypes were compared by chi-square test and survival curves for breast cancer specific survival (BCSS) according to subtypes were plotted by Kaplan-Meier method. The Cox proportional hazards model was performed to search for independent prognostic factors in stage IV breast cancer patients. RESULTS: A total of 11,974 patients were included in this study, among which 7,100 (59.30%) patients were of HR+/HER2-, 2,093 (17.48%) of HR+/HER2+, 1,139 (9.51%) of HR-/HER2+ and 1,642 (13.71%) of HR-/HER2-. Multivariate Cox analysis revealed that molecular subtype, age, race, marital status, grade, surgery and chemotherapy were independent prognostic factors for BCSS in de novo stage IV patients. Taking HR+/HER2- patients as reference, HR+/HER2+ patients had better BCSS (HR =0.81, 95% CI: 0.75-0.88, P<0.001), HR-/ HER2- patients had worse BCSS (HR =1.42, 95% CI: 1.29-1.46, P<0.001) and HR-/HER2+ patients had no significant difference (HR =1.03, 95% CI: 0.98-1.08, P=0.188). In patients with different single organ metastases, the prognosis of HR+/HER2+ subtype was the best (except brain metastasis), while that of HR-/HER2- subtype was the worst. CONCLUSIONS: Molecular subtypes were closely associated with the prognosis of de novo stage IV breast cancer. Among the four subtypes, HR+/HER2+ patients had the best prognosis while HR-/HER2- patients had the worst. The prognosis of patients with different single organ metastases was the same, but in patients with brain metastases, HR+/HER2+ ones did not have a significantly better prognosis than other subtypes except triple-negative type. 2021 Gland Surgery. All rights reserved.
BACKGROUND: Molecular subtype, the basis for personalized treatment of breast cancer, is of great value in evaluating prognosis and guiding treatment of early-stage breast cancer. However, its value in stage IV patients remains unclear. In this study, we investigated the association between molecular subtype and prognosis of de novo stage IV breast cancer using Surveillance, Epidemiology, and End Results (SEER) database with the purpose to provide evidence for optimal therapeutic options for breast cancer patients. METHODS: We retrospectively analyzed de novo stage IV breast cancer patients with the SEER Program data from 2010 to 2015. Characteristics of patients with different molecular subtypes were compared by chi-square test and survival curves for breast cancer specific survival (BCSS) according to subtypes were plotted by Kaplan-Meier method. The Cox proportional hazards model was performed to search for independent prognostic factors in stage IV breast cancer patients. RESULTS: A total of 11,974 patients were included in this study, among which 7,100 (59.30%) patients were of HR+/HER2-, 2,093 (17.48%) of HR+/HER2+, 1,139 (9.51%) of HR-/HER2+ and 1,642 (13.71%) of HR-/HER2-. Multivariate Cox analysis revealed that molecular subtype, age, race, marital status, grade, surgery and chemotherapy were independent prognostic factors for BCSS in de novo stage IV patients. Taking HR+/HER2- patients as reference, HR+/HER2+ patients had better BCSS (HR =0.81, 95% CI: 0.75-0.88, P<0.001), HR-/ HER2- patients had worse BCSS (HR =1.42, 95% CI: 1.29-1.46, P<0.001) and HR-/HER2+ patients had no significant difference (HR =1.03, 95% CI: 0.98-1.08, P=0.188). In patients with different single organ metastases, the prognosis of HR+/HER2+ subtype was the best (except brain metastasis), while that of HR-/HER2- subtype was the worst. CONCLUSIONS: Molecular subtypes were closely associated with the prognosis of de novo stage IV breast cancer. Among the four subtypes, HR+/HER2+ patients had the best prognosis while HR-/HER2- patients had the worst. The prognosis of patients with different single organ metastases was the same, but in patients with brain metastases, HR+/HER2+ ones did not have a significantly better prognosis than other subtypes except triple-negative type. 2021 Gland Surgery. All rights reserved.
Entities:
Keywords:
Molecular type; Surveillance, Epidemiology, and End Results program (SEER program); breast cancer; prognosis; stage IV
Authors: Li Tao; Laura Chu; Lisa I Wang; Lisa Moy; Melissa Brammer; Chunyan Song; Marjorie Green; Allison W Kurian; Scarlett L Gomez; Christina A Clarke Journal: Cancer Causes Control Date: 2016-08-05 Impact factor: 2.506
Authors: G Curigliano; H J Burstein; E P Winer; M Gnant; P Dubsky; S Loibl; M Colleoni; M M Regan; M Piccart-Gebhart; H-J Senn; B Thürlimann; F André; J Baselga; J Bergh; H Bonnefoi; S Y Brucker; F Cardoso; L Carey; E Ciruelos; J Cuzick; C Denkert; A Di Leo; B Ejlertsen; P Francis; V Galimberti; J Garber; B Gulluoglu; P Goodwin; N Harbeck; D F Hayes; C-S Huang; J Huober; K Hussein; J Jassem; Z Jiang; P Karlsson; M Morrow; R Orecchia; K C Osborne; O Pagani; A H Partridge; K Pritchard; J Ro; E J T Rutgers; F Sedlmayer; V Semiglazov; Z Shao; I Smith; M Toi; A Tutt; G Viale; T Watanabe; T J Whelan; B Xu Journal: Ann Oncol Date: 2017-08-01 Impact factor: 32.976
Authors: Naren Ramakrishna; Sarah Temin; Sarat Chandarlapaty; Jennie R Crews; Nancy E Davidson; Francisco J Esteva; Sharon H Giordano; Ana M Gonzalez-Angulo; Jeffrey J Kirshner; Ian Krop; Jennifer Levinson; Shanu Modi; Debra A Patt; Edith A Perez; Jane Perlmutter; Eric P Winer; Nancy U Lin Journal: J Clin Oncol Date: 2014-05-05 Impact factor: 44.544
Authors: Laura Cortesi; Angela Toss; Claudia Cirilli; Luigi Marcheselli; Barbara Braghiroli; Federica Sebastiani; Massimo Federico Journal: Int J Cancer Date: 2015-03-23 Impact factor: 7.396
Authors: C M Perou; T Sørlie; M B Eisen; M van de Rijn; S S Jeffrey; C A Rees; J R Pollack; D T Ross; H Johnsen; L A Akslen; O Fluge; A Pergamenschikov; C Williams; S X Zhu; P E Lønning; A L Børresen-Dale; P O Brown; D Botstein Journal: Nature Date: 2000-08-17 Impact factor: 49.962
Authors: Mary Jo Lund; Katrina F Trivers; Peggy L Porter; Ralph J Coates; Brian Leyland-Jones; Otis W Brawley; Elaine W Flagg; Ruth M O'Regan; Sheryl G A Gabram; J William Eley Journal: Breast Cancer Res Treat Date: 2008-03-07 Impact factor: 4.872
Authors: A Goldhirsch; E P Winer; A S Coates; R D Gelber; M Piccart-Gebhart; B Thürlimann; H-J Senn Journal: Ann Oncol Date: 2013-08-04 Impact factor: 32.976