Distribution, clinicopathologic features and survival of breast cancer subtypes in Southern China

Abstract

Breast cancer research and treatment by different subtypes is an inevitable trend. We investigated the clinicopathologic features and outcomes of different breast cancer subtypes in Southern China. A total of 5809 patients with invasive ductal carcinomas were identified. Immunohistochemical (IHC) markers for estrogen receptor (ER), progesterone receptor (PR), Her2/neu, and Ki-67 proliferation index were used to classify cases into five molecular subtypes. Clinicopathologic characteristics and survival rates were analyzed retrospectively. Of all patients, 31.1% were luminal A subtype, 30.4% luminal B (high Ki-67), 13.1% luminal B (Her2/neu+), 9.0% Her2/neu and 16.5% triple negative subtype. Luminal B (high Ki-67) presented primarily in premenopausal patients with the lowest average age (43.0 years). Her2/neu positive tumors were more closely associated with aggressive features including increased tumor size, positive lymph node status and lymphvascular invasion (LVI). Triple negative subtype was characterized by poorer histologic grade. Her2/neu positive cases had presented the worst 5-year disease-free survival (DFS) and overall survival (OS). Multivariate analyses of OS and DFS suggested that there were different negative prognostic factors for the five subtypes. The benefit of the cyclophosphamide, methotrexate, and 5-fluorouracil (5FU) (CMF) regimen was equal to that of anthracycline-based and Taxane-based regimens for patients with luminal A subtype and triple negative subtype, but inferior to anthracycline-based and Taxane-based regimens for those with two luminal B subtypes and Her2/neu subtype. The prognostic significance of traditional markers may differ among subtypes. This study revealed the distinct clinicopathologic characteristics, systemic therapy benefits, prognostic factors and survival rate among different breast cancer subtypes.

Trends and Present Treatment Patterns of Early Breast Cancer in Southwest China

“…A body of evidences showed that Luminal A patients have the best prognosis, followed by the Luminal B, triple negative and HER2/neu positive patients [21,26], in accordance with our research. The lymph node status is also one predictor for prognosis of breast cancer.…”

“…In this study, we analyzed the profiles and the treatment patterns of breast The median age at diagnosis was 47 years in current study, which was similar to the previous studies within China but earlier than that reported for Western Caucasian [24] . The main subtype of breast cancer was Luminal type and more than half of patients (52.5 %) were diagnosed with Luminal type cancer in this study, which was lower compared to 67 % reported in United States [25] and 74.6 % in Guangzhou, China [26] . The proportion of patients with triple-negative breast cancer was reported to be varied from 10.2 to 30.6 % [25,[27][28][29][30] and about 18.5 % of patients in China were diagnosed with this subtype [31], which was similar to that reported in current study (15.8 %).…”

Molecular breast cancer subtypes and therapies in a public hospital of Northeastern Brazil

“…Corresponding to this high percentage of HER2+ tumors, results revealed an increased frequency (14.50%) of HER2 subtype, compared to data obtained for Western Europe (5.2%), Western Africa (9.00%), Northern Africa (9.20%), China (9.0% and 13.70%), and Afro-American populations (10.10%) [11,15,28,29,37,38]. …”

Characteristics of Special Type Breast Tumors in Our Center

“…However, our luminal type medullary cancer cases were more prevalent than those described in the literature. In the literature, the two year disease-free survival was reported at 79% for basal type medullary breast cancer (12). In our study, two cases which were basal-like died during the follow-up period.…”