Locoregional recurrence by tumor biology in breast cancer patients after preoperative chemotherapy and breast conservation treatment

Eunjin Jwa, Kyung Hwan Shin, Ja Young Kim, Young Hee Park, So Youn Jung, Eun Sook Lee, In Hae Park, Keun Seok Lee, Jungsil Ro, Yeon Joo Kim, Tae Hyun Kim

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Abstract

Purpose The purpose of this study is to determine whether breast cancer subtype can affect locoregional recurrence (LRR) and ipsilateral breast tumor recurrence (IBTR) after neoadjuvant chemotherapy (NAC) and breast-conserving therapy (BCT). Materials and Methods We evaluated 335 consecutive patients with clinical stage II-III breast cancer who received NAC plus BCT from 2002 to 2009. Patients were classified according to six molecular subtypes: luminal A (hormone receptor [HR]+/HER2-/Ki-67 < 15%, n=113), luminal B1 (HR+/HER2-/Ki-67 ≥ 15%, n=33), luminal B2 (HR+/HER2+, n=83), HER2 with trastuzumab (HER2[T+]) (HR-/HER2+/use of trastuzumab, n=14), HER2 without trastuzumab (HER2[T-]) (HR-/HER2+, n=31), and triple negative (TN) (HR-/HER2-, n=61). Results After a median follow-up period of 7.2 years, 26 IBTRs and 37 LRRs occurred. The 5-year LRR-free survival rates were luminal A, 96.4%; B1, 93.9%; B2, 90.3%; HER2(T+), 92.9%; HER2(T-), 78.3%; and TN, 79.6%. The 5-year IBTR-free survival rates were luminal A, 97.2%; B1, 93.9%; B2, 92.8%; HER2(T+), 92.9%; HER2(T-), 89.1%; and TN, 84.6%. In multivariate analysis, HER2(T-) (IBTR: hazard ratio, 4.2; p=0.04 and LRR: hazard ratio, 7.6; p < 0.01) and TN subtypes (IBTR: hazard ratio, 6.9; p=0.01 and LRR: hazard ratio, 8.1; p < 0.01) were associated with higher IBTR and LRR rates. A pathologic complete response (pCR) was found to show correlation with better LRR and a tendency toward improved IBTR controls in TN patients (IBTR, p=0.07; LRR, p=0.03). Conclusion The TN and HER2(T-) subtypes predict higher rates of IBTR and LRR after NAC and BCT. A pCR is predictive of improved IBTR or LRR in TN subtype.

Original languageEnglish
Pages (from-to)1363-1372
Number of pages10
JournalCancer Research and Treatment
Volume48
Issue number4
DOIs
StatePublished - 1 Jan 2016

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Breast
Breast Neoplasms
Recurrence
Drug Therapy
Neoplasms
Therapeutics
Hormones
Survival Rate
Multivariate Analysis

Keywords

  • Breast neoplasms
  • Ipsilateral breast tumor recurrence
  • Local neoplasm recurrence
  • Molecular subtype
  • Neoadjuvant chemotherapy

Cite this

Jwa, Eunjin ; Shin, Kyung Hwan ; Kim, Ja Young ; Park, Young Hee ; Jung, So Youn ; Lee, Eun Sook ; Park, In Hae ; Lee, Keun Seok ; Ro, Jungsil ; Kim, Yeon Joo ; Kim, Tae Hyun. / Locoregional recurrence by tumor biology in breast cancer patients after preoperative chemotherapy and breast conservation treatment. In: Cancer Research and Treatment. 2016 ; Vol. 48, No. 4. pp. 1363-1372.
@article{56f775e2cef24c2894c646b791ca57cf,
title = "Locoregional recurrence by tumor biology in breast cancer patients after preoperative chemotherapy and breast conservation treatment",
abstract = "Purpose The purpose of this study is to determine whether breast cancer subtype can affect locoregional recurrence (LRR) and ipsilateral breast tumor recurrence (IBTR) after neoadjuvant chemotherapy (NAC) and breast-conserving therapy (BCT). Materials and Methods We evaluated 335 consecutive patients with clinical stage II-III breast cancer who received NAC plus BCT from 2002 to 2009. Patients were classified according to six molecular subtypes: luminal A (hormone receptor [HR]+/HER2-/Ki-67 < 15{\%}, n=113), luminal B1 (HR+/HER2-/Ki-67 ≥ 15{\%}, n=33), luminal B2 (HR+/HER2+, n=83), HER2 with trastuzumab (HER2[T+]) (HR-/HER2+/use of trastuzumab, n=14), HER2 without trastuzumab (HER2[T-]) (HR-/HER2+, n=31), and triple negative (TN) (HR-/HER2-, n=61). Results After a median follow-up period of 7.2 years, 26 IBTRs and 37 LRRs occurred. The 5-year LRR-free survival rates were luminal A, 96.4{\%}; B1, 93.9{\%}; B2, 90.3{\%}; HER2(T+), 92.9{\%}; HER2(T-), 78.3{\%}; and TN, 79.6{\%}. The 5-year IBTR-free survival rates were luminal A, 97.2{\%}; B1, 93.9{\%}; B2, 92.8{\%}; HER2(T+), 92.9{\%}; HER2(T-), 89.1{\%}; and TN, 84.6{\%}. In multivariate analysis, HER2(T-) (IBTR: hazard ratio, 4.2; p=0.04 and LRR: hazard ratio, 7.6; p < 0.01) and TN subtypes (IBTR: hazard ratio, 6.9; p=0.01 and LRR: hazard ratio, 8.1; p < 0.01) were associated with higher IBTR and LRR rates. A pathologic complete response (pCR) was found to show correlation with better LRR and a tendency toward improved IBTR controls in TN patients (IBTR, p=0.07; LRR, p=0.03). Conclusion The TN and HER2(T-) subtypes predict higher rates of IBTR and LRR after NAC and BCT. A pCR is predictive of improved IBTR or LRR in TN subtype.",
keywords = "Breast neoplasms, Ipsilateral breast tumor recurrence, Local neoplasm recurrence, Molecular subtype, Neoadjuvant chemotherapy",
author = "Eunjin Jwa and Shin, {Kyung Hwan} and Kim, {Ja Young} and Park, {Young Hee} and Jung, {So Youn} and Lee, {Eun Sook} and Park, {In Hae} and Lee, {Keun Seok} and Jungsil Ro and Kim, {Yeon Joo} and Kim, {Tae Hyun}",
year = "2016",
month = "1",
day = "1",
doi = "10.4143/crt.2015.456",
language = "English",
volume = "48",
pages = "1363--1372",
journal = "Cancer Research and Treatment",
issn = "1598-2998",
publisher = "Korean Cancer Association",
number = "4",

}

Locoregional recurrence by tumor biology in breast cancer patients after preoperative chemotherapy and breast conservation treatment. / Jwa, Eunjin; Shin, Kyung Hwan; Kim, Ja Young; Park, Young Hee; Jung, So Youn; Lee, Eun Sook; Park, In Hae; Lee, Keun Seok; Ro, Jungsil; Kim, Yeon Joo; Kim, Tae Hyun.

In: Cancer Research and Treatment, Vol. 48, No. 4, 01.01.2016, p. 1363-1372.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Locoregional recurrence by tumor biology in breast cancer patients after preoperative chemotherapy and breast conservation treatment

AU - Jwa, Eunjin

AU - Shin, Kyung Hwan

AU - Kim, Ja Young

AU - Park, Young Hee

AU - Jung, So Youn

AU - Lee, Eun Sook

AU - Park, In Hae

AU - Lee, Keun Seok

AU - Ro, Jungsil

AU - Kim, Yeon Joo

AU - Kim, Tae Hyun

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Purpose The purpose of this study is to determine whether breast cancer subtype can affect locoregional recurrence (LRR) and ipsilateral breast tumor recurrence (IBTR) after neoadjuvant chemotherapy (NAC) and breast-conserving therapy (BCT). Materials and Methods We evaluated 335 consecutive patients with clinical stage II-III breast cancer who received NAC plus BCT from 2002 to 2009. Patients were classified according to six molecular subtypes: luminal A (hormone receptor [HR]+/HER2-/Ki-67 < 15%, n=113), luminal B1 (HR+/HER2-/Ki-67 ≥ 15%, n=33), luminal B2 (HR+/HER2+, n=83), HER2 with trastuzumab (HER2[T+]) (HR-/HER2+/use of trastuzumab, n=14), HER2 without trastuzumab (HER2[T-]) (HR-/HER2+, n=31), and triple negative (TN) (HR-/HER2-, n=61). Results After a median follow-up period of 7.2 years, 26 IBTRs and 37 LRRs occurred. The 5-year LRR-free survival rates were luminal A, 96.4%; B1, 93.9%; B2, 90.3%; HER2(T+), 92.9%; HER2(T-), 78.3%; and TN, 79.6%. The 5-year IBTR-free survival rates were luminal A, 97.2%; B1, 93.9%; B2, 92.8%; HER2(T+), 92.9%; HER2(T-), 89.1%; and TN, 84.6%. In multivariate analysis, HER2(T-) (IBTR: hazard ratio, 4.2; p=0.04 and LRR: hazard ratio, 7.6; p < 0.01) and TN subtypes (IBTR: hazard ratio, 6.9; p=0.01 and LRR: hazard ratio, 8.1; p < 0.01) were associated with higher IBTR and LRR rates. A pathologic complete response (pCR) was found to show correlation with better LRR and a tendency toward improved IBTR controls in TN patients (IBTR, p=0.07; LRR, p=0.03). Conclusion The TN and HER2(T-) subtypes predict higher rates of IBTR and LRR after NAC and BCT. A pCR is predictive of improved IBTR or LRR in TN subtype.

AB - Purpose The purpose of this study is to determine whether breast cancer subtype can affect locoregional recurrence (LRR) and ipsilateral breast tumor recurrence (IBTR) after neoadjuvant chemotherapy (NAC) and breast-conserving therapy (BCT). Materials and Methods We evaluated 335 consecutive patients with clinical stage II-III breast cancer who received NAC plus BCT from 2002 to 2009. Patients were classified according to six molecular subtypes: luminal A (hormone receptor [HR]+/HER2-/Ki-67 < 15%, n=113), luminal B1 (HR+/HER2-/Ki-67 ≥ 15%, n=33), luminal B2 (HR+/HER2+, n=83), HER2 with trastuzumab (HER2[T+]) (HR-/HER2+/use of trastuzumab, n=14), HER2 without trastuzumab (HER2[T-]) (HR-/HER2+, n=31), and triple negative (TN) (HR-/HER2-, n=61). Results After a median follow-up period of 7.2 years, 26 IBTRs and 37 LRRs occurred. The 5-year LRR-free survival rates were luminal A, 96.4%; B1, 93.9%; B2, 90.3%; HER2(T+), 92.9%; HER2(T-), 78.3%; and TN, 79.6%. The 5-year IBTR-free survival rates were luminal A, 97.2%; B1, 93.9%; B2, 92.8%; HER2(T+), 92.9%; HER2(T-), 89.1%; and TN, 84.6%. In multivariate analysis, HER2(T-) (IBTR: hazard ratio, 4.2; p=0.04 and LRR: hazard ratio, 7.6; p < 0.01) and TN subtypes (IBTR: hazard ratio, 6.9; p=0.01 and LRR: hazard ratio, 8.1; p < 0.01) were associated with higher IBTR and LRR rates. A pathologic complete response (pCR) was found to show correlation with better LRR and a tendency toward improved IBTR controls in TN patients (IBTR, p=0.07; LRR, p=0.03). Conclusion The TN and HER2(T-) subtypes predict higher rates of IBTR and LRR after NAC and BCT. A pCR is predictive of improved IBTR or LRR in TN subtype.

KW - Breast neoplasms

KW - Ipsilateral breast tumor recurrence

KW - Local neoplasm recurrence

KW - Molecular subtype

KW - Neoadjuvant chemotherapy

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U2 - 10.4143/crt.2015.456

DO - 10.4143/crt.2015.456

M3 - Article

C2 - 26910473

AN - SCOPUS:84996605852

VL - 48

SP - 1363

EP - 1372

JO - Cancer Research and Treatment

JF - Cancer Research and Treatment

SN - 1598-2998

IS - 4

ER -