Differential patterns of recurrence and specific survival between luminal A and luminal B breast cancer according to recent changes in the 2013 St Gallen immunohistochemical classification

García-Fernández, Antonio; Chabrera, Carolina; Font, Marc García; Fraile, Manel; Lain, J. M.; González, Sónia; Barco, Israel; González, Carles Benedí; Torres, Jennifer; Piqueras, Mercè; Cirera, Lluís; Veloso, E; Pessarrodona, Antoni; Giménez, Núria

doi:10.1007/s12094-014-1220-8

Cited by 20 publications

(17 citation statements)

References 35 publications

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“…Prat et al. [30] proposed that the IHC‐based definition of luminal A‐like breast cancer is HR positivity, HER2 negativity, Ki‐67 index <14%, and PR expression >20% which led to the modification of the definition of luminal A‐like breast cancer in the 2013 St. Gallen criteria [21]. When the concordance between the 2013 St. Gallen criteria and the Surexam® 21‐gene RS / IHC3 model were calculated in the present study, we observed that almost all patients with luminal A‐like breast cancer were categorized in the RS <26 and pLR groups.…”

Section: Discussionmentioning

confidence: 99%

“…In this study, the patients were stratified into luminal A‐like and luminal B‐like (HER2‐negative) groups based on the 2013 St. Gallen criteria [21]. The luminal A‐like group (deemed to have low‐recurrence risk) included patients with ER‐positive breast cancer, PR expression ≥20%, HER2‐negative breast cancer, and Ki‐67 index <14%.…”

Section: Methodsmentioning

confidence: 99%

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Ki‐67 index, progesterone receptor expression, histologic grade and tumor size in predicting breast cancer recurrence risk: A consecutive cohort study

Zhang

Zhou

Mao

et al. 2020

Cancer Communications

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Background:The 21-gene recurrence score (RS) assay has been recommended by major guidelines for treatment decision in hormone receptor (HR)-positive early breast cancer (EBC). However, the genomic assay is not accessible and affordable worldwide. Alternatively, an increasing number of studies have shown that traditional immunohistochemistry (IHC) can partially or even completely replace the role of the 21-gene genomic assay. Here, we developed and validated a predictive model (IHC3 model) combining the Ki-67 index, progesterone receptor (PR) expression, histologic grade, and tumor size to predict the recurrence risk of HR-positive EBC. Methods: The data from 389 patients (development set) with HR-positive, human epidermal growth factor receptor 2-negative, lymph node non-metastasized invasive breast cancer were used to construct the IHC3 model based on the Surexam ® 21gene RS and the TAILORx clinical trial criteria. An additional 146 patients with the same characteristics constituted the validation set. The predictive accuracy of the IHC3 model was compared with that of Orucevic et al.'s nomogram. Invasive diseasefree survival (IDFS) was analyzed in the IHC3 predictive low-recurrence risk (pLR) group and the predictive high-recurrence risk (pHR) group. The Pearson chi-square test, Fisher exact test, and log-rank test were used for analysis. Results: The pLR and pHR group could be easily stratified using the decision tree model without network dependence. The accuracies of the IHC3 model were 86.1% in the development set and 87.7% in the validation set. The predictive accuracy of the IHC3 model and Orucevic et al.'s nomogram for the whole cohort was 86.5% and 86.9%, respectively. After a 52-month of median follow-up, a significant difference Abbreviations: ALND, axillary lymph node dissection; CART, classification and regression trees; EBC, early breast cancer; ER, estrogen receptor; FISH, fluorescence in situ hybridization; HER2, human epidermal growth factor receptor 2; HR, hormone receptor; IDC, invasive ductal carcinoma; IDFS, invasive disease-free survival; IHC, immunohistochemistry; ILC, invasive lobular carcinoma; NPV, negative predictive value; pHR, predictive high-recurrence risk; pLR, predictive low-recurrence risk; PPV, positive predictive value; PR, progesterone receptor; RS, recurrence score; SERM, selective estrogen receptor modulator; SLNB, sentinel lymph node biopsy.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Ki‐67 index, progesterone receptor expression, histologic grade and tumor size in predicting breast cancer recurrence risk: A consecutive cohort study

Zhang

Zhou

Mao

et al. 2020

Cancer Communications

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“…The analyses were visualized as heat maps. As luminal type breast cancer can be divided into two subgroups, luminal A and luminal B [ 17 ], the differentially expressed genes in luminal breast cancer patients were extracted for cluster analysis to evaluate the efficacy of the proposed method for subdividing this single breast cancer subtype into personalized subgroups. The basal-like type of breast cancer was then analyzed to identify intrinsic subgroups.…”

Section: Methodsmentioning

confidence: 99%

Identification of Personalized Chemoresistance Genes in Subtypes of Basal-Like Breast Cancer Based on Functional Differences Using Pathway Analysis

Wang

et al. 2015

PLoS ONE

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Breast cancer is a highly heterogeneous disease that is clinically classified into several subtypes. Among these subtypes, basal-like breast cancer largely overlaps with triple-negative breast cancer (TNBC), and these two groups are generally studied together as a single entity. Differences in the molecular makeup of breast cancers can result in different treatment strategies and prognoses for patients with different breast cancer subtypes. Compared with other subtypes, basal-like and other ER+ breast cancer subtypes exhibit marked differences in etiologic factors, clinical characteristics and therapeutic potential. Anthracycline drugs are typically used as the first-line clinical treatment for basal-like breast cancer subtypes. However, certain patients develop drug resistance following chemotherapy, which can lead to disease relapse and death. Even among patients with basal-like breast cancer, there can be significant molecular differences, and it is difficult to identify specific drug resistance proteins in any given patient using conventional variance testing methods. Therefore, we designed a new method for identifying drug resistance genes. Subgroups, personalized biomarkers, and therapy targets were identified using cluster analysis of differentially expressed genes. We found that basal-like breast cancer could be further divided into at least four distinct subgroups, including two groups at risk for drug resistance and two groups characterized by sensitivity to pharmacotherapy. Based on functional differences among these subgroups, we identified nine biomarkers related to drug resistance: SYK, LCK, GAB2, PAWR, PPARG, MDFI, ZAP70, CIITA and ACTA1. Finally, based on the deviation scores of the examined pathways, 16 pathways were shown to exhibit varying degrees of abnormality in the various subgroups, indicating that patients with different subtypes of basal-like breast cancer can be characterized by differences in the functional status of these pathways. Therefore, these nine differentially expressed genes and their associated functional pathways should provide the basis for novel personalized clinical treatments of basal-like breast cancer.

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“…Os estudos brasileiros mostram resultados de SLD para câncer de mama, subtipo luminal, de 93,38% 11 . Dentre estudos internacionais, as taxas de sobrevida para o subtipo luminal variam entre 93,3 12 , 96,0 13 e 94,0% 14 , e a heterogeneidade observada nos resultados pode ser resultado de diferenças metodológicas 15 .…”

Section: Resultsunclassified

“…A média de idade de 57,8 anos observada nesta coorte também apresenta similaridade com as análises obtidas em outro estudo 15 , indicando a necessidade de solicitação de mais exames na menopausa, tais como a mamografia. 16 .…”

Section: Resultsunclassified

Sobrevida de mulheres com câncer de mama subtipo luminal assistidas em Juiz de Fora, MG

Carmo¹,

Leite²,

Guerra³

2016

Rev. Bras. Mastol. (Impr.)

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Objetivo: Estimar a sobrevida livre de doença em cinco anos de mulheres com câncer de mama subtipo luminal, diagnosticadas entre 2003 e 2005, em Juiz de Fora, Minas Gerais, e a associação com variáveis prognósticas, clínicas, sociodemográficas, histopatológicas e relacionadas aos serviços de saúde e tratamento. Métodos: Utilizou-se coorte de base hospitalar englobando um total de 331 mulheres com imuno-histoquímica de tumor luminal, não metastático, diagnosticadas entre 2003 e 2005, em hospital de referência oncológica. Foram analisadas variáveis sociodemográficas, tumorais e relativas ao tratamento. Resultados: A sobrevida livre de doença em cinco anos na população de estudo foi de 79,5% (74,6-83,6). Observou-se associação da recorrência do tumor com o tipo de serviço, estadiamento, tamanho tumoral e comprometimento linfonodal (p<0,05). Melhor sobrevida foi observada no uso de serviço privado de saúde, doença inicial, menor tamanho tumoral, ausência de comprometimento linfonodal e uso de hormonioterapia. No modelo final de Cox, a gravidade da doença e a hormonioterapia foram importantes fatores prognósticos independentes. Conclusão: Os estádios avançados da doença devem ser objeto de abordagem terapêutica mais ampliada e deve-se garantir, quando indicado, o acesso ao tratamento hormonal, incluindo os casos de tumores da mama classificados como luminais, que, em princípio, exibem melhor prognóstico.

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Differential patterns of recurrence and specific survival between luminal A and luminal B breast cancer according to recent changes in the 2013 St Gallen immunohistochemical classification

Abstract: GH3, PR, and Ki67 may all be discriminatory factors for metastasis and specific mortality. Therefore, we suggest including GH3 in the luminal B subtype in the absence of Ki67.

Cited by 20 publications

References 35 publications

Ki‐67 index, progesterone receptor expression, histologic grade and tumor size in predicting breast cancer recurrence risk: A consecutive cohort study

Ki‐67 index, progesterone receptor expression, histologic grade and tumor size in predicting breast cancer recurrence risk: A consecutive cohort study

Identification of Personalized Chemoresistance Genes in Subtypes of Basal-Like Breast Cancer Based on Functional Differences Using Pathway Analysis

Sobrevida de mulheres com câncer de mama subtipo luminal assistidas em Juiz de Fora, MG

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