Association of molecular subtyping with clinicopathologic features and prognosis in breast cancer patients with axillary lymph node metastasis / 肿瘤

ABSTRACT

Objective: The aim of this study was to explore the association of different molecular subtypes with the clinicopathologic features and the prognosis in breast cancer patients with axillary lymph node metastasis. Methods: The clinicopathologic information of 181 operable breast cancer patients with axillary lymph node metastasis was retrospectively analyzed. These patients were classified into different groups according to molecular subtyping. All patients were followed-up with a median of 58 months (range 44-68 months). The multivariate analysis was performed to evaluate the prognostic indicators among the potential factors including age, primary tumor size, number of metastatic axillary lymph nodes and molecular subtype. Results: Of all 181 patients, 58.0% (105/181) were luminal subtype, 24.3% (44/181) were basal-like subtype, and 17.7% (32/181) were HER-2 overexpression subtype. HER-2 overexpression was closely associated with increased tumor size and more positive lymph nodes. The relapse rates of luminal, basal-like and HER-2 overexpression subtypes were 17.1% (18/105), 31.8% (14/44) and 37.5% (12/32), respectively (P = 0.026); the death rates of luminal, basal-like and HER-2 overexpression subtypes were 6.7% (7/105), 13.6% (6/44) and 18.8% (6/32), respectively (luminal vs non-luminal, P = 0.048). The five-year disease-free survival rate of patients with luminal subtype was much higher than those of the patients with HER-2 overexpression and basal-like subtypes (log-rank test, P = 0.025); the five-year overall survival rate of patients with luminal subtype was also much higher than that of patients with HER-2 overexpression subtype (log-rank test, P = 0.039). COX proportional hazards model revealed that primary tumor size and the number of metastatic axillary lymph nodes were both independent prognostic indicators (P > 0.05). Conclusion: In axillary lymph node-positive breast cancer patients not receiving targeted molecular therapy, the subtype of HER-2 overexpression has the worst prognosis while the subtype of luminal has the best. The primary tumor size and the number of metastatic axillary lymph nodes were both independent prognostic indicators for breast cancer patients. Copyright © 2013 by TUMOR.