J Breast Cancer.  2011 Mar;14(1):46-51. 10.4048/jbc.2011.14.1.46.

Patterns of Recurrence after Breast-Conserving Treatment for Early Stage Breast Cancer by Molecular Subtype

• Noh JM
• Choi DH
• Huh SJ
• Park W
• Yang JH
• Nam SJ
• Im YH
• Ahn JS

• KMID: 2175642
• DOI: http://doi.org/10.4048/jbc.2011.14.1.46

Abstract

PURPOSE
To study clinical features and patterns of recurrence after breast-conserving treatment (BCT) for three molecular subtypes of early stage breast cancer.
METHODS
The sample studied included 596 patients with T1-2N0-1 breast cancer who received BCT. Three groups were defined by receptor status. Luminal: estrogen receptor (ER) or progesterone receptor (PR) positive; triple negative (TN): ER, PR, and epidermal growth factor receptor-2 (HER2) receptor negative; and HER2 overexpressing: ER and PR negative but HER2 receptor positive.
RESULTS
The number of patients in each group was 408 (68.5%), 105 (17.6%), and 83 (13.9%), respectively. The median follow-up period was 79 months. The TN and HER2 subtypes occurred in younger patients (p=0.0007) and had higher nuclear grade and poorer histologic grade (p<0.0001 and 0.0071, respectively). During the follow-up period, locoregional recurrence was detected as the first site of recurrence in 26 (6.4%), 11 (10.5%), and 9 (10.8%) patients in the luminal, TN, and HER2 subtypes, respectively (p=0.1924). Thirty-one (7.6%), 7 (6.7%), and 7 (8.4%) patients in each group had distant metastases as the first sign of recurrence (p=0.8996). Median time to locoregional and distant recurrence was shorter in the HER2 subtype (p=0.0889 and 0.0780, respectively), and the HER2 subtype was significantly associated with poor overall survival (p=0.0009).
CONCLUSION
After BCT in Korean women with early stage breast cancer, the patterns of recurrence were not different among the molecular subtypes, although the TN and HER2 subtypes were associated with younger age, higher nuclear grade, and poorer histologic grade.

Keyword

Breast-conserving surgery; Breast neoplasms; erbB-2 receptor; Estrogen receptors; Progesterone receptors; Recurrence

MeSH Terms

Breast
Breast Neoplasms
Epidermal Growth Factor
Estrogens
Female
Follow-Up Studies
Humans
Mastectomy, Segmental
Neoplasm Metastasis
Phenobarbital
Receptor, erbB-2
Receptors, Estrogen
Receptors, Progesterone
Recurrence
Epidermal Growth Factor
Estrogens
Phenobarbital
Receptor, erbB-2
Receptors, Estrogen
Receptors, Progesterone

Figure

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  Figure 1 Cumulative incidence of locoregional recurrence as the first event.

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  Figure 2 Cumulative incidence of distant metastasis as the first site of recurrence.

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  Figure 3 Overall survival after breast-conserving treatment for early stage breast cancer.

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  Figure 4 Disease free survival after breast-conserving treatment for early stage breast cancer.

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