Annals of Oncology Advance Access originally published online on September 15, 2006
Annals of Oncology 2006 17(11):1631-1636; doi:10.1093/annonc/mdl296
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© 2006 European Society for Medical Oncology
breast cancer |
Clinical outcome of adjuvant endocrine treatment according to PR and HER-2 status in early breast cancer
1 Academic Units of Gynaecological Oncology, University of Turin, Institute for Cancer Research and Treatment (IRCC) of Candiolo, A.S.O. Ordine Mauriziano, Turin, Italy
2 Medical Oncology, University of Turin, Institute for Cancer Research and Treatment (IRCC) of Candiolo, A.S.O. Ordine Mauriziano, Turin, Italy
3 Department of Public Health and Microbiology, University of Turin, Turin, Italy
* Correspondence to: Dr R. Ponzone, Institute for Cancer Research and Treatment (IRCC), Strada Provinciale 142, 10060 Candiolo, Turin, Italy. Tel: +39-011-9933444; Fax: +39-011-9933447; E-mail: rponzone{at}mauriziano.it
Patients with estrogen receptor (ER)+/progesterone receptor (PR)– and/or HER-2 overexpressing breast carcinomas may derive lower benefit from endocrine treatment. We examined retrospectively data from 972 breast cancer patients who received tamoxifen (725), tamoxifen + Gn-RH analogs (127) and aromatase inhibitors (120) as adjuvant treatments. ER+/PR– versus ER+/PR+ tumours were characterised by larger size (P = 0.001), higher tumour grade (P = 0.001), higher Ki-67 expression (P = 0.001) and lower mean ER (P = 0.000) and HER-2 expression (P = 0.000). At univariate analysis, tumour grading [hazard ratio (HR) = 4.0; 95% confidence interval (CI) = 1.4–11.1; P = 0.007], nodal status (HR = 3.4; 95% CI 1.2–5.7; P = 0.000), tumour diameter (HR = 2.9; 95% CI 1.7–4.7; P = 0.000) lack of PR expression (HR = 2.1; 95% CI 1.3–3.4; P = 0.002) and HER-2 overexpression (HR = 1.9; 95% CI 1.0–3.5; P = 0.03), as well as Ki 67 expression (HR = 1.7; 95% CI 1.0–2.7; P = 0.04) were associated with shorter disease-free survival (DFS). At the multivariate analysis, nodal status (HR = 3.6; 95% CI 1.9–6.8; P = 0.0001), lack of PR expression (HR = 2.3; 95% CI 1.3–4.0; P = 0.003) and tumour diameter (HR = 2.1; 95% CI 1.1–3.8; P = 0.018) retained their prognostic significance, whereas HER-2 overexpression was associated with a trend towards shorter DFS that was of borderline statistical significance (HR = 2.0; 95 % CI 1.0–3.9; P = 0.05). Our data suggest that lack of PR expression and HER-2 overexpression are both associated with aggressive tumour features, but the prognostic information of PR status on the risk of recurrence in endocrine-treated breast cancer patients is stronger.
Key words: adjuvant, breast neoplasm, endocrine therapy, estrogen receptor, HER-2, progesterone receptor
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