Universität zu Köln

Christgen, Matthias, Gluz, Oleg, Harbeck, Nadia, Kates, Ronald E., Raap, Mieke, Christgen, Henriette, Clemens, Michael, Malter, Wolfram, Nuding, Benno, Aktas, Bahriye, Kuemmel, Sherko, Reimer, Toralf, Stefek, Andrea, Krabisch, Petra, Just, Marianne, Augustin, Doris, Graeser, Monika, Baehner, Frederick, Wuerstlein, Rachel, Nitz, Ulrike and Kreipe, Hans (2020). Differential impact of prognostic parameters in hormone receptor-positive lobular breast cancer. Cancer, 126 (22). S. 4847 - 4859. HOBOKEN: WILEY. ISSN 1097-0142

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Abstract

Background Invasive lobular breast cancer (BC) is the second most common BC subtype. Prognostic parameters (tumor classification, lymph node status, histologic grade, Oncotype DX recurrence score [RS], progesterone receptor status, and Ki67 index) were retrospectively studied in a large, prospective clinical trial encompassing 2585 patients who had hormone receptor-positive early BC (the West German Study Group PlanB trial). Methods BCs were centrally reviewed and classified as lobular (n = 353; 14%) or nonlobular (n = 2232; 86%). The median follow-up was 60 months. Five-year disease-free survival (DFS) estimates were obtained using the Kaplan-Meier method. Prognostic parameters were evaluated using Cox proportional hazard models. Results Lobular BC was associated with higher tumor classification, higher lymph node status, lower histologic grade, lower Ki67 index, and low or intermediate RS. The prevalence of high RS (RS range, 26-100) was 3-fold lower in patients who had lobular BC compared with those who had nonlobular BC (8% vs 24%;P < .001). However, 5-year DFS estimates for lobular and nonlobular BC were similar (92.1% and 92.3%, respectively;P = .673). In multivariate analyses, prognostic parameters for DFS in lobular BC included grade 3 (hazard ratio, 5.06; 95% CI, 1.91-13.39) and a pathologic lymph node status (pN) of pN3 (hazard ratio, 12.16; 95% CI, 3.87-38.24), but not RS. By contrast, prognostic parameters in nonlobular BC included grade 3 (hazard ratio, 1.65; 95% CI, 1.11-2.44), pN3 (hazard ratio, 3.68; 95% CI, 1.60-8.46), and high RS (hazard ratio, 2.49; 95% CI, 1.69-3.68). Conclusions Lobular BC is associated with low and intermediate RS, although 5-year DFS is similar to that of nonlobular BC. The effect of the RS in lobular BC appears to be distinct from that in nonlobular BC. For risk assessment, the RS needs to be complemented by clinicopathologic parameters for therapy decision making.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Christgen, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Gluz, Oleg UNSPECIFIED UNSPECIFIED UNSPECIFIED Harbeck, Nadia UNSPECIFIED UNSPECIFIED UNSPECIFIED Kates, Ronald E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Raap, Mieke UNSPECIFIED UNSPECIFIED UNSPECIFIED Christgen, Henriette UNSPECIFIED UNSPECIFIED UNSPECIFIED Clemens, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Malter, Wolfram UNSPECIFIED UNSPECIFIED UNSPECIFIED Nuding, Benno UNSPECIFIED UNSPECIFIED UNSPECIFIED Aktas, Bahriye UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuemmel, Sherko UNSPECIFIED UNSPECIFIED UNSPECIFIED Reimer, Toralf UNSPECIFIED UNSPECIFIED UNSPECIFIED Stefek, Andrea UNSPECIFIED UNSPECIFIED UNSPECIFIED Krabisch, Petra UNSPECIFIED UNSPECIFIED UNSPECIFIED Just, Marianne UNSPECIFIED UNSPECIFIED UNSPECIFIED Augustin, Doris UNSPECIFIED UNSPECIFIED UNSPECIFIED Graeser, Monika UNSPECIFIED UNSPECIFIED UNSPECIFIED Baehner, Frederick UNSPECIFIED UNSPECIFIED UNSPECIFIED Wuerstlein, Rachel UNSPECIFIED UNSPECIFIED UNSPECIFIED Nitz, Ulrike UNSPECIFIED UNSPECIFIED UNSPECIFIED Kreipe, Hans UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-323473
DOI:	10.1002/cncr.33104
Journal or Publication Title:	Cancer
Volume:	126
Number:	22
Page Range:	S. 4847 - 4859
Date:	2020
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1097-0142
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CARCINOMA; RECURRENCE; GRADE; KI67; CHEMOTHERAPY; TAMOXIFEN; FEATURES; THERAPY; ASSAY Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/32347