Annals of Oncology Advance Access published online on September 15, 2006
Annals of Oncology, doi:10.1093/annonc/mdl296
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1 Academic Units of Gynaecological Oncology, Institute for Cancer Research and Treatment (IRCC) of Candiolo, A.S.O. Ordine Mauriziano, Turin
* To whom correspondence should be addressed. 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.
Received March 18, 2006
Revised July 6, 2006
Accepted July 7, 2006
original article
Clinical outcome of adjuvant endocrine treatment according to PR and HER-2 status in early breast cancer
R. Ponzone 1 *, F. Montemurro 2, F. Maggiorotto 1, C. Robba 1, D. Gregori 3, M. E. Jacomuzzi 1, F. Kubatzki 1, D. Marenco 1, A. Dominguez 1, N. Biglia 1, and P. Sismondi 1
2 Medical Oncology, University of Turin, Institute for Cancer Research and Treatment (IRCC) of Candiolo, A.S.O. Ordine Mauriziano, Turin
3 Department of Public Health and Microbiology, University of Turin, Turin, Italy
R. Ponzone, E-mail: rponzone{at}mauriziano.it
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