HER2 status and disparities in luminal breast cancers

Abstract

National Comprehensive Care Network guidelines for adjuvant treatment of invasive breast cancer are based on HER2 and hormone receptor (HR) status, where HR+ disease encompasses all estrogen receptor (ER)+ and/or progesterone receptor (PR)+ tumors. We sought to explore clinical and demographic differences among patients with HR+ breast cancer subtypes, and the role of HER2 status, age, race/ethnicity, and socioeconomic status (SES) in disease risk. We evaluated breast cancer subtype distribution, defined by HR and HER2 status, using patient clinical, demographic, and socioeconomic characteristics. Differences in HR categories by demographic and tumor characteristics were examined using chi‐squared tests. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) to quantify associations between breast cancer HR status and demographic factors. We found that differences in HR+ (ER−/PR+ vs. ER+/PR− or ER+/PR+) tumor biology are likely clinically significant and may play a role in breast cancer, regardless of HER2 status. While clinical and patient characteristics differed within each luminal subtype, we found disparities in SES only among Luminal A (HR+/HER2−) tumors. Among HR+/HER2− cases, we observed that ER−/PR+ patients tend to live in areas of higher poverty (OR = 1.20, 95% CI = 1.03–1.40) and are 70% more likely to be aged 50 years or older. However, this pattern was not found in women with Luminal B (HR+/HER2+) disease (Poverty OR = 0.98, 95% CI = 0.76–1.27; Age OR = 1.01, 95% CI = 0.81–1.26). Racial/ethnic disparities among non‐Hispanic black and Hispanic women persisted across HR+/HER2− cases compared to non‐Hispanic white women. Our findings suggest that while race/ethnicity and SES are correlated, each plays an independent role in contributing to disease among Luminal A tumors. Further study is needed to investigate how tumor biology, race/ethnicity, and socioeconomic disparities among HR+/HER2− cases may contribute to poorer patient prognosis.

Intravoxel incoherent motion magnetic resonance imaging for breast cancer: A comparison with benign lesions and evaluation of heterogeneity in different tumor regions with prognostic factors and molecular classification

“…Luminal A cancer exhibited increased slow ADC and decreased fast ADC compared with other subtypes. It has previously been established that Luminal B cancers have a poorer prognosis and a distinctive response to systemic therapy, compared with Luminal A cancers ( 50 ). In the case of ER positive or PR positive tumors, the slow ADC and fast ADC values may be of use to distinguish Luminal B from Luminal A cancer.…”

The olive oil phenolic (-)-oleocanthal modulates estrogen receptor expression in luminal breast cancer in vitro and in vivo and synergizes with tamoxifen treatment

“…Luminal breast cancers account for about 60% of all cases (Holowatyj et al, 2016). Luminal tumors are positive for hormone receptor and are further classified based on HER2 receptor status (Holowatyj et al, 2016; Polyak, 2011).…”

“…Luminal tumors are positive for hormone receptor and are further classified based on HER2 receptor status (Holowatyj et al, 2016; Polyak, 2011). Luminal A breast cancers are positive to estrogen receptor (ER) and/or progesterone receptor (PR) but HER2-negative (Holowatyj et al, 2016). In contrast, luminal B tumors demonstrate HER2-enrichment and could be positive to one or both hormone receptors (Holowatyj et al, 2016).…”

“…Luminal A breast cancers are positive to estrogen receptor (ER) and/or progesterone receptor (PR) but HER2-negative (Holowatyj et al, 2016). In contrast, luminal B tumors demonstrate HER2-enrichment and could be positive to one or both hormone receptors (Holowatyj et al, 2016). Furthermore, luminal A tumors are characterized by low expression of the proliferation marker Ki67 while luminal B cancers have been reported to have high expression of Ki67 (Holliday and Speirs, 2011; Li et al, 2016; Subik et al, 2010).…”

The prognostic value of quantitative analysis of CCL5 and collagen IV in luminal B (HER2–) subtype breast cancer by quantum-dot-based molecular imaging

“…2 According to the St Gallen 2015 definitions, the proportion of luminal (HER2-) cancer is 71% and luminal B-like (HER2+) is 6%, 3 and race/ethnicity and socioeconomic status are independent in contributing to disease among luminal A tumors, but not found in women with luminal B (HR+/HER2+) disease. 4 The clinicopathological features of luminal B breast cancer are similar to those of luminal A breast cancer, but luminal B cancer has a higher heterogeneity and poorer prognosis than luminal A, 5,6 and there is a higher proportion of local recurrence and single bone metastasis in patients with luminal B breast cancer than in patients in the nonluminal groups. 7 The hormone receptor status in this type of breast cancer is positive; thus, endocrine therapy was performed in all cases, but the treatment was not satisfactory, 8 and a significant number of cases received very little benefit from chemotherapy.…”