HER2 Support Group Forums - View Single Post - Patterns of Recurrence Differ by Breast Cancer Node-Negative Subtype

'lizbeth · 08-14-2013, 09:29 AM

J Clin Oncol. 2013 Jul 29. [Epub ahead of print]
Patterns of Recurrence and Outcome According to Breast Cancer Subtypes in Lymph Node-Negative Disease: Results From International Breast Cancer Study Group Trials VIII and IX.

Metzger-Filho O, Sun Z, Viale G, Price KN, Crivellari D, Snyder RD, Gelber RD, Castiglione-Gertsch M, Coates AS, Goldhirsch A, Cardoso F.
Source

Otto Metzger-Filho, Dana-Farber Cancer Institute; Zhuoxin Sun, Dana-Farber Cancer Institute, Harvard School of Public Health; Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research Foundation, Boston, MA; Giuseppe Viale, European Institute of Oncology and University of Milan; Aron Goldhirsch, European Institute of Oncology, Milan; Diana Crivellari, Centro di Riferimento Oncologico, Aviano, Italy; Raymond D. Snyder, St. Vincent's Hospital, Melbourne; Alan S. Coates, University of Sydney, Sydney, Australia; Monica Castiglione-Gertsch, University Hospital, Geneva; Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland; and Fatima Cardoso, Champalimaud Cancer Center, Lisbon, Portugal.

Abstract

PURPOSETo retrospectively evaluate the pattern of recurrence and outcome of node-negative breast cancer (BC) according to major subtypes. PATIENTS AND METHODSIn all, 1,951 patients with node-negative, early-stage BC randomly assigned in International Breast Cancer Study Group Trials VIII and IX with centrally reviewed pathology data were included. BC subtypes were defined as triple negative (TN; n = 310), human epidermal growth factor receptor 2 (HER2) positive (n = 369), and hormone receptor positive with high (luminal B-like [LB-like]; n = 763) or low (luminal A-like [LA-like]; n = 509) proliferative activity by Ki-67 labeling index. BC-free interval (BCFI) events were invasive BC recurrence in local, contralateral breast, nodal, bone, or visceral sites. Time to first site-specific recurrence was evaluated by using cumulative incidence and competing risks regression analysis.ResultsMedian follow-up was 12.5 years. The 10-year BCFI was higher for patients with LA-like (86%) BC compared with LB-like (76%), HER2 (73%), and TN (71%; P < .001) BC. TN and HER2 cohorts had higher hazard of BCFI event in the first 4 years after diagnosis (pre-trastuzumab). LB-like cohorts had a continuously higher hazard of BCFI event over time compared with LA-like cohorts. Ten-year overall survival was higher for LA-like (89%) compared with LB-like (83%), HER2 (77%), and TN (75%; P < .001) BC. LB-like subtypes had higher rates of bone as first recurrence site than other subtypes (P = .005). Visceral recurrence as first site was lower for the LA-like subgroup, with similar incidence among the other subgroups when treated with chemotherapy (P = .003). CONCLUSIONBC subtypes have different distant recurrence patterns over time. Defining different patterns of BC recurrence can improve BC care through surveillance guidelines and can guide the design of clinical studies.

08-14-2013, 09:29 AM	#2
'lizbeth Senior Member Join Date: Apr 2008 Location: Sunny San Diego Posts: 2,214	Re: Patterns of Recurrence Differ by Breast Cancer Node-Negative Subtype J Clin Oncol. 2013 Jul 29. [Epub ahead of print] Patterns of Recurrence and Outcome According to Breast Cancer Subtypes in Lymph Node-Negative Disease: Results From International Breast Cancer Study Group Trials VIII and IX. Metzger-Filho O, Sun Z, Viale G, Price KN, Crivellari D, Snyder RD, Gelber RD, Castiglione-Gertsch M, Coates AS, Goldhirsch A, Cardoso F. Source Otto Metzger-Filho, Dana-Farber Cancer Institute; Zhuoxin Sun, Dana-Farber Cancer Institute, Harvard School of Public Health; Richard D. Gelber, Dana-Farber Cancer Institute, Harvard School of Public Health, Harvard Medical School; Karen N. Price, Frontier Science and Technology Research Foundation, Boston, MA; Giuseppe Viale, European Institute of Oncology and University of Milan; Aron Goldhirsch, European Institute of Oncology, Milan; Diana Crivellari, Centro di Riferimento Oncologico, Aviano, Italy; Raymond D. Snyder, St. Vincent's Hospital, Melbourne; Alan S. Coates, University of Sydney, Sydney, Australia; Monica Castiglione-Gertsch, University Hospital, Geneva; Alan S. Coates, International Breast Cancer Study Group, Bern, Switzerland; and Fatima Cardoso, Champalimaud Cancer Center, Lisbon, Portugal. Abstract PURPOSETo retrospectively evaluate the pattern of recurrence and outcome of node-negative breast cancer (BC) according to major subtypes. PATIENTS AND METHODSIn all, 1,951 patients with node-negative, early-stage BC randomly assigned in International Breast Cancer Study Group Trials VIII and IX with centrally reviewed pathology data were included. BC subtypes were defined as triple negative (TN; n = 310), human epidermal growth factor receptor 2 (HER2) positive (n = 369), and hormone receptor positive with high (luminal B-like [LB-like]; n = 763) or low (luminal A-like [LA-like]; n = 509) proliferative activity by Ki-67 labeling index. BC-free interval (BCFI) events were invasive BC recurrence in local, contralateral breast, nodal, bone, or visceral sites. Time to first site-specific recurrence was evaluated by using cumulative incidence and competing risks regression analysis.ResultsMedian follow-up was 12.5 years. The 10-year BCFI was higher for patients with LA-like (86%) BC compared with LB-like (76%), HER2 (73%), and TN (71%; P < .001) BC. TN and HER2 cohorts had higher hazard of BCFI event in the first 4 years after diagnosis (pre-trastuzumab). LB-like cohorts had a continuously higher hazard of BCFI event over time compared with LA-like cohorts. Ten-year overall survival was higher for LA-like (89%) compared with LB-like (83%), HER2 (77%), and TN (75%; P < .001) BC. LB-like subtypes had higher rates of bone as first recurrence site than other subtypes (P = .005). Visceral recurrence as first site was lower for the LA-like subgroup, with similar incidence among the other subgroups when treated with chemotherapy (P = .003). CONCLUSIONBC subtypes have different distant recurrence patterns over time. Defining different patterns of BC recurrence can improve BC care through surveillance guidelines and can guide the design of clinical studies.