|
for those w slightly bigger (t1b,c)node- her2+ tumors trying 2 decide on treatment 2
High recurrence risk in pT1bc HER2-positive, triple-negative, node-negative early breast cancer patients.
Sub-category:
HER2+
Category:
Breast Cancer - HER2/ER
Meeting:
2011 ASCO Annual Meeting
Abstract No:
609
Citation:
J Clin Oncol 29: 2011 (suppl; abstr 609)
Session: Breast Cancer - HER2/ER
Type: General Poster Session
Time: Monday June 6, 1:00 PM to 5:00 PM
Location: McCormick Place Hall A
Personalize your Annual Meeting experience with a suggested or customized itinerary!
Author(s): A. Vaccaro, F. Ciancola, L. Pizzuti, I. Sperduti, L. Moscetti, P. Vici, F. Longo, E. Ruggeri, M. Di Seri, M. A. Giampaolo, T. Gamucci; Medical Oncology Unit ASL Frosinone, Frosinone, Italy; Sapienza, Policlinico Umberto I, Rome, Italy; Medical Oncology, Regina Elena National Cancer Institute, Rome, Italy; Regina Elena National Cancer Institute, Rome, Italy; UOC Oncologia Presidio Ospedaliero Centrale Belcolle - AUSL, Viterbo, Italy; Belcolle Hospital, Viterbo, Italy; Medical Oncology Unit, ASL Frosinone, Frosinone, Italy
Abstract Disclosures
Abstract:
Background: Controversy still exists about adjuvant treatment decision for small node negative (N0) early breast cancer (BC). Retrospective evaluations of clinical and pathological data show different outcomes. The objective of our analysis is to evaluate recurrence risk in patients (pts) with pT1abc, N0 BC accordingly with some prognostic biological factors. Methods: We retrospectively evaluated 600 pts who underwent surgery between 2000 and 2009 in 4 italian oncologic centers. Survival analysis was performed only for pts enrolled until December 2007 (563 pts) in order to obtain a minimum follow up (FU) of 3 years (yr). Results: Median age at diagnosis 59 (range 21-86); premenopausal 28%; invasive ductal carcinoma 89%; Ki 67>15% 51%; histologic grade (G)1 17%, G2 50%, G3 18%, no data in 15% of pts; pT1a 8%; pT1b 37%; pT1c 55%. We defined 3 cohorts: ER positive (ER+) 82%; HER2 overexpressed or amplified (HER2+) 10%; triple negative (TN) 8%. All ER+ pts received adjuvant hormonal treatment. Chemotherapy (CT) was administered in 35% of pts (pT1c 47%, pT1b 23%, pT1a 10%). In HER2+ cohort CT (plus trastuzumab in 50% of pts) was administered in 35/62 pts (57%) and in TN pts 35/50 (70%). Median FU was 60 months. To date 11% of pts recurred. The 5-yr disease free survival (DFS) and overall survival (OS) were 91.3.% and 97.7%. DFS according to different cohorts is shown in table. In pT1bc pts there is a trend towards a higher rate of recurrence (HR 1.62, 95% CI 0.80-3.07; p 0.14) in HER2+ and TN cohorts and DFS according to tumor size is b+c vs a with HR 4.43 (95% CI 0.61-31.97; p 0.14). At Cox multivariate analysis Ki67 and histologic G resulted as independent prognostic factors (HR 2.11, 95% CI 1.07-4.15; HR 2.58, 95% CI 1.26–5.25). Conclusions: Grading and Ki67 are confirmed independent prognostic factors. pT1b or c, N0, HER2+ and TN BC have a significant high risk of recurrence. In pT1c HER2+ pts DFS is presumably related to the high percentage (85%) of trastuzumab-treated pts. Effective therapy should be considered for all these unfavourable prognostic subgroups. Data collection is ongoing and update results will be presented.
DFS 5-yr % P
All pT1 a 100 0.11
b 90.7
c 90.7
ER+ pT1 a 100 0.11
b 94.4
c 90.5
TN pT1 a 100 0.74
b 82.8
c 83.9
HER2 + pT1 a 100 0.35
b 77.4
c 90.6
|
Linear Mode
