Influences of adjuvant treatments in hormone receptor positive breast cancer on receptor conversion in recurrent breast cancer
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To examine influences on the receptor status of a local cohort of patients with recurrent breast cancer after primary diagnosis of hormone receptor positive breast cancer.
We retrospectively analyzed 2078 female patients with primary hormone receptor positive breast cancer treated at the university hospital of Wuerzburg between 2000 and 2013. Main focus was on discordance in receptor status in recurrent disease.
196 patients with the primary diagnosis of hormone receptor positive breast cancer developed recurrent disease. 29.1% of patients revealed discordance in estrogen receptor (ER), progesterone receptor (PgR) or HER2 receptor (ER+ to −: 33.3%; PgR+ to −: 59.6%; HER2+ to −: 8.8%; HER2− to +: 17.5%). Aggressive tumor biology such as low grading or involvement of axillary lymph nodes showed increased risk of receptor conversion in relapse. Premenopausal patients with adjuvant application of tamoxifen and the application of chemotherapy had a significantly lower risk for the development of ER negative recurrent disease. Receptor changes to ER and PgR negativity in recurrent disease showed a trend to worse overall survival (OS).
Histological analysis of recurrent disease is indispensable, since one-third of patients with hormone receptor positive breast cancer develop change in the receptor status.
KeywordsRecurrent disease Breast cancer Receptor discordance Hormone receptor
We would like to thank Professor Dr. Manfred Wischnewsky, Department of Mathematics and Computer Science, University of Bremen for statistical advice.
TNS: conceptualization, investigation, software, supervision, visualization, writing of original draft. CRW: data curation, software, formal analysis, methodology, writing parts of the original draft and editing. AW: conceptualization, funding acquisition, project administration, editing of the manuscript. SH: conceptualization, investigation, project administration, supervision, editing the manuscript. All authors contributed to the final manuscript including interpretation of data and review of the literature.
TN. Stueber was funded by the Interdisciplinary Center for Clinical Research at the University hospital of Wuerzburg and the Else Kroener-Fresenius-Stiftung
Compliance with ethical standards
Conflict of interest
TN. Stueber: received fees from Roche Pharma; CR Weiss: none; A. Woeckel: received fees from Roche, Pfizer, Novartis, Amgen, Celgene, Eisai; S. Haeusler: received fees from Novartis and Roche Pharma.
As the study consisted of the retrospective analysis of anonymized data according to the local ethics committee a special approval is generally not required.
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