Ann Surg Treat Res.  2023 Jan;104(1):1-9. 10.4174/astr.2023.104.1.1.

Prognosis according to the timing of recurrence in breast cancer

• Lee YJ
• Jung SP
• Bae JW
• Yang SM
• You JY
• Bae SY

• KMID: 2537621
• DOI: http://doi.org/10.4174/astr.2023.104.1.1

Abstract

Purpose
Clinically, breast cancer can be divided into 4 subtypes based on the presence of hormone receptors, human epidermal growth factor receptor 2 (HER2), and Ki-67. Because the pattern and time of recurrence vary according to the subtype, we evaluated whether there was a difference in overall survival (OS) among the subtypes according to the time and type of recurrence.
Methods
A total of 2,730 patients who underwent breast cancer surgery were analyzed. Early and late recurrence were defined as recurrence within and after 5 years of diagnosis, respectively. Recurrence type was categorized as locoregional recurrence or systemic recurrence.
Results
Hormone receptor-positive tumors were significantly more frequent in the late recurrence group than in the early recurrence group (estrogen receptor positive, 47.8% [early] vs. 78.7% [late]). However, there was no difference in the rate of HER2 overexpression (HER2+, 38.1% [early] vs.39.0% [late]). In subgroup analysis, early recurrence was a significant prognostic factor for OS in all subtypes. However, late recurrence was a significant prognostic factor for OS only in the luminal B subtype (hazard ratio of 4.30). In addition, the luminal B type had the highest proportion in late recurrence patients (63.2%).
Conclusion
The luminal B subtype had a high rate of late recurrence, and late recurrence was a poor prognostic factor for OS only in this subgroup. Therefore, further targeted treatments for luminal B breast cancer are needed and patients with this subtype require close long-term surveillance.

Keyword

Breast neoplasms; Prognosis; Recurrence; Time

Figure

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  Fig. 1 Overall survival (OS) according to recurrence type. (A) Locoregional recurrence. (B) Systemic recurrence.

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  Fig. 2 Overall survival (OS) according to chemotherapy. (A) Total patients. (B) Neoadjuvant chemotherapy. (C) Adjuvant chemotherapy. (D) No chemotherapy.

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  Fig. 3 Overall survival (OS) according to subtype. (A) Luminal A. (B) Luminal B. (C) Triple-negative breast cancer. (D) Human epidermal growth factor receptor 2 (HER2)-positive subtype.

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