Long-term survival analysis of different breast cancer molecular subtypes: Shanghai Breast Cancer Survival Study / 中华外科杂志
Chinese Journal of Surgery
; (12): 928-934, 2015.
Article
in Chinese
| WPRIM (Western Pacific)
| ID: wpr-349238
Responsible library:
WPRO
ABSTRACT
<p><b>OBJECTIVES</b>To analyze the survival of breast cancer molecular subtypes and to examine the effect of therapy on the long-term prognosis of different subtypes.</p><p><b>METHODS</b>This study included 3 586 breast cancer patients with estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor-2 (HER2) information in Shanghai Breast Cancer Survival Study, a population-based prospective cohort study established in 2002. Molecular subtypes, based on immunohistochemistry were categorized as follows Luminal A, Luminal B, HER2, and triple-negative subtype. Characteristics and clinical data were collected through questionnaires and medical records at baseline survey and sequential follow-up surveys. Survival rates of different molecular subtypes were analyzed and compared with Log-rank tests. Multiple Cox regression models were used to evaluate the effect of therapy on long-term prognosis of different molecular subtypes.</p><p><b>RESULTS</b>Among the 3 586 cases, Luminal A, Luminal B, HER2 and triple-negative breast cancer subtypes accounted for 54.5%, 16.6%, 13.9%, and 14.9%, respectively. With a median follow-up of 10.3 years (ranging 0.6 to 12.8 years), the 10-year overall survival (OS) rates for the four subtypes were 82.7% (95% CI 80.9% to 84.4%), 77.7% (95% CI 74.1% to 80.8%), 76.3% (95% CI 72.3% to 79.8%), and 74.8% (95% CI 70.9% to 78.3%), respectively. The 10-year disease to free survival (DFS) rates were 79.0% (95% CI 76.7% to 81.0%), 76.0% (95% CI 71.9% to 79.5%), 73.6% (95% CI 68.9% to 77.7%), and 74.5% (95% CI 69.4% to 78.9%), respectively. Significant difference in survival among four subtypes was observed (Log-rank test, P<0.01). Multivariate Cox regression indicated that hormonal therapy can significantly reduce the long-term risk of total mortality and recurrence breast cancer specific mortality among Luminal A subtype patients. Adjuvant chemotherapy could improve the long-term prognosis of triple-negative breast cancer. No benefit from radiotherapy was observed for four subtypes of breast cancer in terms of long-term prognosis.</p><p><b>CONCLUSIONS</b>Molecular subtypes based on ER/PR/HER2 could provide important information to predict breast cancer prognosis. The hormonal status was an important basis for individualized therapy and precision medicine.</p>
Full text:
Available
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Breast Cancer
Database:
WPRIM (Western Pacific)
Main subject:
Prognosis
/
Breast Neoplasms
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Immunohistochemistry
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Receptors, Progesterone
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Receptors, Estrogen
/
Proportional Hazards Models
/
Survival Rate
/
Prospective Studies
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Cohort Studies
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Chemotherapy, Adjuvant
Type of study:
Etiology study
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Incidence study
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Observational study
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Prognostic study
/
Risk factors
Limits:
Humans
Language:
Chinese
Journal:
Chinese Journal of Surgery
Year:
2015
Document type:
Article