Studies on the distant relapse-free survival after relapse of different subtypes of breast cancer

doi:10.3877/cma.j.issn.1674-0793.2013.04.011

Abstract

Abstract:

Objective

To investigate the distant relapse-free survival, as well as survival after relapse, among different subtypes of breast cancer.

Methods

Patients with operable primary invasive breast cancer diagnosed in Zhongshan City People's Hospital from Jan. 1998 to Dec. 2004 were recruited. Subtypes were defined as luminal A, luminal B, human epidermal growth factor receptor 2 (HER2) enriched, and triple negative (TN) according to the expression of Estrogen Receptor (ER), Progestogen Receptor (PR) and HER2 status. The time of the appearance of the first distant metastasis and death of patients were recorded.

Results

Two hundred and fifteen (55.1%) patients were luminal A, 43 (11.0%) were luminal B, 52 (13.3%) were HER2 enriched, and 80 (20.5%) were TN. The median follow-up time was 118 months. In the first three years after operation, 19 (8.8%) and 2 (4.7%) metastases occurred in patients with luminal A and luminal B type of breast cancer, respectively. Patients with HER2 (19.2%) and TN type (20.0%) of breast cancer had a significantly higher metastasis rate than those with luminal type of breast cancer (P < 0.05). There's no significant difference of metastasis rate among the four subgroups during 37 months to 72 months after operation. Patients with luminal types of breast cancer had a higher rate of metastasis than patients with other types of breast cancer in the period of 73 months to 108 months after operation (P < 0.05). Median durations of survival with distant metastasis were 28 months for luminal A, 22 for luminal B, 9 for HER2, and 6 for TN (P < 0.05), respectively.

Conclusions

The subtypes of breast cancer are associated with distinct patterns of metastatic spread with notable differences in survival after relapse. Patients with HER2 type or TN type of breast cancer develop metastasis earlier than patients with luminal type of breast cancer did. The duration of survival after metastasis is longer for patients with luminal type of breast cancer than patients with other types of breast cancer. However, for patients with luminal types of breast cancer, the chance of relapse always exist, even in a relatively long time after operation.

Key words: Breast cancer, Subtypes, Metastasis

Shi-en CUI, Fei-hai LING, Bing CHU. Studies on the distant relapse-free survival after relapse of different subtypes of breast cancer[J]. Chinese Archives of General Surgery(Electronic Edition), 2013, 07(04): 289-294.

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Figures/Tables 4

References 10

1	Spitale A, Mazzola P, Soldini D, et al. Breast cancer classification according to immunohistochemical markers: clinicopathologic features and short-term survival analysis in a population-based study from the South of Switzerland. Ann Oncol, 2009, 20(4): 628-635.
2	Michael G, Nadia H, Christoph T. St. Gallen 2011: Summary of the Consensus Discussion. Breast Care (Basel), 2011, 6(2): 136-141.
3	Perou CM, Sorlie T, Eisen MB, et al. Molecular portraits of human breast tumours. Nature, 2000, 406(6797): 747-752.
4	骆成玉. 乳腺癌乳腔镜腋窝淋巴结清扫手术的临床实践与思考[J/CD]. 中华腔镜外科杂志:电子版, 2010, 3(1): 23-27.
5	邹菊，王松，梁庆模.乳腺癌新辅助化疗疗效的评价方法[J/CD].中华普通外科学文献:电子版, 2012, 6(1): 71-74.
6	Hugh J, Hanson J, Cheang MCU, et al. Breast cancer subtypes and response to docetaxel in node positive breast cancer; use of an immunohistochemical definition in the BCIRG 001 Trial. J Clin Oncol, 2009, 27(8): 1168-1176.
7	Zaha DC, Lazar E, Lazureanu C. Clinicopathologic features and five years survival analysis in molecular subtypes of breast cancer. Rom J Morphol Embryol, 2010, 51(1): 85-89.
8	Sorlie T, Perou CM, Tibshirani R, et al.Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA, 2001, 98(19): 10869-10874.
9	Kennecke HF, Olivotto IA, Speers C, et al. Late risk of relapse and mortality among postmenopausal women with estrogen responsive early breast cancer after 5 years of tamoxifen. Ann Oncol, 2007, 18(1): 45-51.
10	Kennecke H, Yerushalmi R, Woods R, et al. Metastatic behavior of breast cancer subtypes. J Clin Oncol, 2010, 28(20): 3271-3277.

项目		Luminal A型	Luminal B型	HER2型	三阴性型	P值
年龄(岁)		?	?	?	?	0.48
?	≤40	14 (6.5)	3 (7.0)	1 (1.9)	7 (8.8)	?
?	> 40	201 (93.5)	40 (93.0)	51 (98.1)	73 (91.2)	?
肿瘤大小（cm）		?	?	?	?	0.21
?	≤2	132 (61.4)	25 (58.1)	27 (51.9)	39 (48.8)	?
?	> 2	83 (38.6)	18 (41.9)	25 (48.1)	41 (51.2)	?
肿瘤分级		?	?	?	?	?
?	Ⅰ	9 (4.2)	2 (4.7)	1 (1.9)	3 (3.8)	0.13
?	Ⅱ	177 (82.3)	29 (67.4)	37 (71.1)	59 (73.8)	?
?	Ⅲ	29 (13.5)	12 (27.9)	14 (26.9)	18 ( 22.5)	?
腋淋巴结状态		?	?	?	?	0.68
?	阴性	133 (61.9)	24 (55.8)	34 (65.4)	53 (66.3)	?
?	阳性	82 (38.1)	19 (44.2)	18 (34.6)	27 (33.8)	?

项目		Luminal A型	Luminal B型	HER2型	三阴性型	P值
年龄(岁)		?	?	?	?	0.48
?	≤40	14 (6.5)	3 (7.0)	1 (1.9)	7 (8.8)	?
?	> 40	201 (93.5)	40 (93.0)	51 (98.1)	73 (91.2)	?
肿瘤大小（cm）		?	?	?	?	0.21
?	≤2	132 (61.4)	25 (58.1)	27 (51.9)	39 (48.8)	?
?	> 2	83 (38.6)	18 (41.9)	25 (48.1)	41 (51.2)	?
肿瘤分级		?	?	?	?	?
?	Ⅰ	9 (4.2)	2 (4.7)	1 (1.9)	3 (3.8)	0.13
?	Ⅱ	177 (82.3)	29 (67.4)	37 (71.1)	59 (73.8)	?
?	Ⅲ	29 (13.5)	12 (27.9)	14 (26.9)	18 ( 22.5)	?
腋淋巴结状态		?	?	?	?	0.68
?	阴性	133 (61.9)	24 (55.8)	34 (65.4)	53 (66.3)	?
?	阳性	82 (38.1)	19 (44.2)	18 (34.6)	27 (33.8)	?

时间		新出现转移数					累计转移病例数
时间		L-A	L-B	HER2	TN	P值	L-A （215例）	L-B （43例）	HER2 （52例）	TN （80例）	P值
术后3年		?	?	?	?	?	?	?	?	?	?
?	转移	19	2	10	16	< 0.05	19	2	10	16	< 0.05
?	无转移	196	41	42	64	?	196	41	42	64	?
术后6年		?	?	?	?	?	?	?	?	?	?
?	转移	14	2	0	1	0.13	33	4	10	17	0.33
?	无转移	182	39	42	63	?	182	39	42	63	?
术后9年		?	?	?	?	?	?	?	?	?	?
?	转移	4	6	0	0	< 0.05	37	8	10	17	0.88
?	无转移	178	35	42	63	?	178	35	42	63	?

时间		新出现转移数					累计转移病例数
时间		L-A	L-B	HER2	TN	P值	L-A （215例）	L-B （43例）	HER2 （52例）	TN （80例）	P值
术后3年		?	?	?	?	?	?	?	?	?	?
?	转移	19	2	10	16	< 0.05	19	2	10	16	< 0.05
?	无转移	196	41	42	64	?	196	41	42	64	?
术后6年		?	?	?	?	?	?	?	?	?	?
?	转移	14	2	0	1	0.13	33	4	10	17	0.33
?	无转移	182	39	42	63	?	182	39	42	63	?
术后9年		?	?	?	?	?	?	?	?	?	?
?	转移	4	6	0	0	< 0.05	37	8	10	17	0.88
?	无转移	178	35	42	63	?	178	35	42	63	?

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