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Journal of Cancer Research and Clinical Oncology

, Volume 144, Issue 7, pp 1347–1355 | Cite as

Patterns of breast cancer relapse in accordance to biological subtype

  • Atanas Ignatov
  • Holm Eggemann
  • Elke Burger
  • Tanja Ignatov
Original Article – Clinical Oncology

Abstract

Purpose

To evaluate the pattern of recurrence of breast cancer according to its biological subtype in a large cohort of patients treated with therapy representative of current practice.

Patients and methods

Patients treated between 2000 and 2016 with known biological subtype were eligible. Data were prospectively collected. Primary endpoint was the subtype-dependent pattern and time of recurrence. Loco-regional and distant site and time of recurrence were assessed.

Results

Median follow-up time was 80.8 months. For 12,053 (82.5%) of 14,595 patients with primary non-metastatic invasive breast cancer a subtype classification was possible. The luminal A subtype had the highest 10-year survival followed by luminal B and luminal/HER2. The worst survival demonstrated HER2 enriched and TNBC. HER2 and TNBC had the highest rate of recurrence in the first 5 years, whereas the rate of recurrence for luminal A and luminal B tumors was initially low, but remained continuously even after 10 years of follow-up. Luminal A tumors demonstrated the lowest rate of distant metastases predominantly in bone. So did luminal B tumors. HER2 enriched subtype was characterized with increased rate of loco-regional recurrence and distant metastases in bone, liver and brain. Luminal/HER2 had pattern of relapse similar to HER2 enriched tumors, with exception of loco-regional relapse and brain metastases. TNBC had higher rate of lung, bone and brain metastases as well as loco-regional relapse.

Conclusion

Breast cancer subtypes are associated with different time and pattern of recurrence and it should be considered during treatment decision.

Keywords

Breast cancer Subtype Recurrence Metastasis 

Notes

Funding

This study was not funded.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors. Research and Ethical Committee, Otto-von-Guericke University, Magdeburg, Germany proved the study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Written informed consent was obtained from all patients before treatment. An additional individual consent for this analysis was not needed. Before analysis, patient data underwent a pesudonymisation.

References

  1. Cheang MC, Chia SK, Voduc D, Gao D, Leung S, Snider J, Watson M, Davies S, Bernard PS, Parker JS, Perou CM, Ellis MJ, Nielsen TO (2009) Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst 101(10):736–750CrossRefPubMedPubMedCentralGoogle Scholar
  2. Colleoni M, Sun Z, Price KN, Karlsson P, Forbes JF, Thurlimann B, Gianni L, Castiglione M, Gelber RD, Coates AS, Goldhirsch A (2016) Annual hazard rates of recurrence for breast cancer during 24 years of follow-up: results from the international breast cancer study group trials I to V. J Clin Oncol 34(9):927–935CrossRefPubMedPubMedCentralGoogle Scholar
  3. Cossetti RJ, Tyldesley SK, Speers CH, Zheng Y, Gelmon KA (2015) Comparison of breast cancer recurrence and outcome patterns between patients treated from 1986 to 1992 and from 2004 to 2008. J Clin Oncol 33(1):65–73CrossRefPubMedGoogle Scholar
  4. Early Breast Cancer Trialists’ Collaborative G (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365(9472): 1687–1717CrossRefGoogle Scholar
  5. Eggemann H, Ignatov T, Burger E, Kantelhardt EJ, Fettke F, Thomssen C, Costa SD, Ignatov A (2015) Moderate HER2 expression as a prognostic factor in hormone receptor positive breast cancer. Endocr Relat Cancer 22(5):725–733CrossRefPubMedGoogle Scholar
  6. Gabos Z, Thoms J, Ghosh S, Hanson J, Deschenes J, Sabri S, Abdulkarim B (2010) The association between biological subtype and locoregional recurrence in newly diagnosed breast cancer. Breast Cancer Res Treat 124(1):187–194CrossRefPubMedGoogle Scholar
  7. Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thurlimann B, Senn HJ, Panel m (2011) Strategies for subtypes–dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol 22(8):1736–1747CrossRefPubMedPubMedCentralGoogle Scholar
  8. Gong Y, Liu YR, Ji P, Hu X, Shao ZM (2017) Impact of molecular subtypes on metastatic breast cancer patients: a SEER population-based study. Sci Rep 7:45411CrossRefPubMedPubMedCentralGoogle Scholar
  9. Ignatov T, Eggemann H, Burger E, Costa SD, Ignatov A (2016) Hormone receptor status does not alter the effect of trastuzumab in breast cancer. Endocr Relat Cancer 23(5):349–355CrossRefPubMedGoogle Scholar
  10. Kennecke H, Yerushalmi R, Woods R, Cheang MC, Voduc D, Speers CH, Nielsen TO, Gelmon K (2010) Metastatic behavior of breast cancer subtypes. J Clin Oncol 28(20):3271–3277CrossRefPubMedGoogle Scholar
  11. Metzger-Filho O, Sun Z, Viale G, Price KN, Crivellari D, Snyder RD, Gelber RD, Castiglione-Gertsch M, Coates AS, Goldhirsch A, Cardoso F (2013) 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. J Clin Oncol 31(25):3083–3090CrossRefPubMedPubMedCentralGoogle Scholar
  12. Minn AJ, Gupta GP, Siegel PM, Bos PD, Shu W, Giri DD, Viale A, Olshen AB, Gerald WL, Massague J (2005) Genes that mediate breast cancer metastasis to lung. Nature 436(7050):518–524CrossRefPubMedPubMedCentralGoogle Scholar
  13. Park YH, Lee S, Cho EY, Choi YL, Lee JE, Nam SJ, Yang JH, Ahn JS, Im YH (2010) Patterns of relapse and metastatic spread in HER2-overexpressing breast cancer according to estrogen receptor status. Cancer Chemother Pharmacol 66(3):507–516CrossRefPubMedGoogle Scholar
  14. Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS, Rees CA, Pollack JR, Ross DT, Johnsen H, Akslen LA, Fluge O, Pergamenschikov A, Williams C, Zhu SX, Lonning PE, Borresen-Dale AL, Brown PO, Botstein D (2000) Molecular portraits of human breast tumours. Nature 406(6797):747–752CrossRefPubMedGoogle Scholar
  15. Ribelles N, Perez-Villa L, Jerez JM, Pajares B, Vicioso L, Jimenez B, de Luque V, Franco L, Gallego E, Marquez A, Alvarez M, Sanchez-Munoz A, Perez-Rivas L, Alba E (2013) Pattern of recurrence of early breast cancer is different according to intrinsic subtype and proliferation index. Breast Cancer Res 15(5):R98CrossRefPubMedPubMedCentralGoogle Scholar
  16. Saphner T, Tormey DC, Gray R (1996) Annual hazard rates of recurrence for breast cancer after primary therapy. J Clin Oncol 14(10):2738–2746CrossRefPubMedGoogle Scholar
  17. Smid M, Wang Y, Zhang Y, Sieuwerts AM, Yu J, Klijn JG, Foekens JA, Martens JW (2008) Subtypes of breast cancer show preferential site of relapse. Cancer Res 68(9):3108–3114CrossRefPubMedGoogle Scholar
  18. Voduc KD, Cheang MC, Tyldesley S, Gelmon K, Nielsen TO, Kennecke H (2010) Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol 28(10):1684–1691CrossRefPubMedGoogle Scholar
  19. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP, Initiative S (2007) The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370(9596):1453–1457CrossRefGoogle Scholar
  20. Wu X, Baig A, Kasymjanova G, Kafi K, Holcroft C, Mekouar H, Carbonneau A, Bahoric B, Sultanem K, Muanza T (2016) Pattern of local recurrence and distant metastasis in breast cancer by molecular subtype. Cureus 8(12):e924PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyOtto-von-Guericke UniversityMagdeburgGermany
  2. 2.Institute of Biometry and Medical InformaticsOtto-von-Guericke UniversityMagdeburgGermany

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