Poor prognosis of single hormone receptor- positive breast cancer: similar outcome as triple-negative breast cancer.

Abstract

BACKGROUND:

Response to endocrine therapy in breast cancer correlates with estrogen receptor (ER) and progesterone receptor (PR) status. Generally, hormone receptor-positive (HR+) breast cancers have favorable prognosis. In order to understand the exact clinical characteristics and prognosis of single HR-positive breast cancer (ER + PR- tumors and ER-PR+ tumors), we compared these tumors to double HR+ tumors as well as HR- negative tumors (ER-PR-).

METHODS:

We examined the clinical and biological features of 6,980 women with invasive ductal carcinoma, and these patients were stratified according to ER and PR expression as double HR+ (ER + PR+), single HR+ (ER + PR- and ER-PR+) and double HR-negative (HR-, ER-PR-) tumors.

RESULTS:

In this study, 571 (8.2%) cases were single HR+ tumors, of which 90 (1.3%) were ER-PR+ tumors and 481 (6.9%) were ER + PR- tumors. Our multivariate analysis showed that in patients without HER2 overexpression ER + PR- tumors were associated with an increased risk of recurrence and death compared with ER + PR+ tumors, with a hazard ratio of 2.12 for disease-free survival (DFS) and 4.79 for overall survival (OS). In patients without HER2 overexpression ER-PR+ tumors had increased risk of recurrence and death compared with ER + PR+ tumor, with a hazard ratio of 4.19 for DFS and 7.22 for OS. In contrast, in patients with HER2 overexpression, the difference in survival between single HR+ tumors and double HR+ HR- tumors was not statistically significant. In patients without HER2 overexpression the DFS and OS of ER + PR- and ER-PR+ tumors were not significantly different from those of ER-PR- tumors.

CONCLUSION:

We have identified clinically and biologically distinct features of single HR+ tumors (ER-PR+ and ER + PR-) through comparison with both ER + PR+ and ER-PR- tumors. These differences were only significant in HER2- tumors, not in HER2+ tumors. Single HR+ tumors without HER2 overexpression (ER + PR-HER2- or ER-PR + HER2-) were associated with poorer survival than ER + PR + HER2- tumors, and had comparable poor survival to ER-PR-HER2- tumors (triple-negative breast cancer).

• Authors: Soo Youn Bae, Sangmin Kim, Jun Ho Lee, Hyun-Chul Lee, Se Kyung Lee, Won Ho Kil, Seok Won Kim, Jeong Eon Lee, Seok Jin Nam
• Journal: BMC cancer (BMC Cancer) Vol. 15 Pg. 138 (Mar 18 2015) ISSN: 1471-2407 [Electronic] England
• PMID: 25880075 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers, Tumor
• Receptors, Estrogen
• Receptors, Progesterone
• Receptor, ErbB-2

Topics

• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor
• Breast Neoplasms (drug therapy, genetics, metabolism, mortality, pathology)
• Female
• Follow-Up Studies
• Gene Expression
• Humans
• Middle Aged
• Neoplasm Grading
• Neoplasm Recurrence, Local
• Neoplasm Staging
• Prognosis
• Receptor, ErbB-2 (genetics, metabolism)
• Receptors, Estrogen (genetics, metabolism)
• Receptors, Progesterone (genetics, metabolism)
• Risk Factors
• Survival Analysis
• Triple Negative Breast Neoplasms (drug therapy, genetics, mortality)
• Young Adult