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Clinical Implication of HER2 Status in Hormone Receptor-Positive Mucinous Breast Cancer

  • Sung-chan Gwark
  • Han Shin Lee
  • Youngjoo Lee
  • Sae Byul Lee
  • Guiyun Sohn
  • Jisun Kim
  • Il Yong Chung
  • Beom Seok Ko
  • Hee Jeong Kim
  • Byung Ho Son
  • Jin-Hee Ahn
  • Kyung Hae Jung
  • Sung-Bae Kim
  • Hee Jin Lee
  • Gyung-Yub Gong
  • Sei Hyun Ahn
  • Jong Won LeeEmail author
Breast Oncology

Abstract

Purpose

Mucinous carcinoma (MC) is a rare breast cancer with favorable outcome. Unlike typical breast cancer, the current guidelines do not recommend chemotherapy or anti-human epidermal growth factor receptor 2 (HER2) therapy for hormone receptor (HR)-positive MC, regardless of HER2 status. We evaluated the prognostic implication of HER2 status in HR-positive MC.

Methods

We retrospectively reviewed the data of 471 patients with pure MC (stages I–III) who underwent curative surgery. We analyzed 5-year disease-free survival (DFS) and distant metastasis-free survival (DMFS), according to clinicopathological characteristics.

Results

The median follow-up duration was 79.0 months. Overall, the 5-year DFS rate was 95.7% and the 5-year DMFS rate was 96.2%. Nodal status was the only significant factor for DFS (relative risk [RR], 3.40; 95% confidence interval [CI] 3.40–9.67, p = 0.021). Among HR-positive/node-negative patients with tumor size ≥ 3 cm, HER2-positive patients showed significantly worse DFS (RR, 8.76; 95% CI 1.45–52.76, p = 0.018) and DMFS (RR, 11.37; 95% CI 1.37–74.70, p = 0.011). This finding was consistently significant, when combining both “HR-positive/node-negative/tumor size ≥ 3 cm” and “HR-positive/node-positive” MC (n = 125) for DFS (RR, 4.30; 95% CI 1.43–12.97, p = 0.009) and DMFS (RR, 4.93; 95% CI 1.63–14.90, p = 0.005). Intriguingly, within this subgroup, among HER2-positive tumors, whereas 5-year DFS was 60.2% in patients who did not receive trastuzumab, 100% of those who received trastuzumab were disease free (p = 0.053).

Conclusions

In HR-positive, node-negative MC with tumor size ≥ 3 cm, patients with HER2-positive MC showed worse survival, suggesting a potential role of an anti-HER2 strategy in this subgroup.

Notes

Acknowledgment

This study was supported by a grant (2015-510) from the Asan Institute for Life Sciences and a grant (2017-1347) ‘Elimination of Cancer Project Fund’ from Asan Cancer Institute, Asan Medical Center, Seoul, Korea.

Compliance with Ethical Standards

Disclosure

None.

Conflict of interest

The authors declare no conflict of interest.

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Copyright information

© Society of Surgical Oncology 2019

Authors and Affiliations

  • Sung-chan Gwark
    • 1
  • Han Shin Lee
    • 1
  • Youngjoo Lee
    • 1
  • Sae Byul Lee
    • 1
  • Guiyun Sohn
    • 1
  • Jisun Kim
    • 1
  • Il Yong Chung
    • 1
  • Beom Seok Ko
    • 1
  • Hee Jeong Kim
    • 1
  • Byung Ho Son
    • 1
  • Jin-Hee Ahn
    • 2
  • Kyung Hae Jung
    • 2
  • Sung-Bae Kim
    • 2
  • Hee Jin Lee
    • 3
  • Gyung-Yub Gong
    • 3
  • Sei Hyun Ahn
    • 1
  • Jong Won Lee
    • 1
    Email author
  1. 1.Department of SurgeryUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulSouth Korea
  2. 2.Department of OncologyUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulSouth Korea
  3. 3.Department of PathologyUniversity of Ulsan College of Medicine, Asan Medical CenterSeoulSouth Korea

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