Department of Surgery, Ankara Oncology Training and Research Hospital, Ankara, Turkey.
World J Surg. 2011 Oct;35(10):2196-202. doi: 10.1007/s00268-011-1240-2.
Many studies have investigated the association between the molecular subtypes of breast cancer and survival. The aim of this study was to identify the effects of intrinsic subtypes of breast cancer and the other clinicopathological factors on postmastectomy locoregional recurrence (LRR) in patients with early breast cancer.
The records of 1,195 consecutive early breast cancer patients treated with modified radical mastectomy between 2004 and 2008 were retrospectively evaluated. The effects of intrinsic subtypes of the tumor (luminal A, luminal B, HER2-overexpressing, and triple-negative) and classical clinicopathological factors on LRR were identified by univariate and multivariate statistical analyses.
The median follow-up time was 44 months, and 16 (1.3%) patients experienced a LRR during this period. In univariate analysis, the intrinsic subtypes of breast cancer had a significant effect on LRR (p = 0.002). In multivariate analysis, only extranodal invasion and estrogen receptor (ER) status were significant predictors of LRR (p = 0.003 and 0.0001, respectively), whereas intrinsic subtypes did not reveal a significant relationship with LRR (p = 0.57; hazard ratio, 2.9; 95% confidence interval, 0.2-4.7).
The results of this study suggest that the extranodal invasion and negative ER status should potentially be considered when evaluating the risk of LRR. The predictive power of intrinsic subtypes for LRR is less than that of classical pathological indicators. This information may be useful in planning management of LRR in early breast cancer patients treated with mastectomy.
许多研究已经探讨了乳腺癌分子亚型与生存之间的关系。本研究的目的是确定乳腺癌内在亚型和其他临床病理因素对早期乳腺癌患者乳腺癌根治术后局部区域复发（LRR）的影响。
回顾性评估了 2004 年至 2008 年间接受改良根治性乳房切除术的 1195 例连续早期乳腺癌患者的记录。通过单因素和多因素统计分析，确定肿瘤内在亚型（管腔 A、管腔 B、HER2 过表达和三阴性）和经典临床病理因素对 LRR 的影响。
中位随访时间为 44 个月，在此期间 16 例（1.3%）患者发生 LRR。在单因素分析中，乳腺癌内在亚型对 LRR 有显著影响（p = 0.002）。在多因素分析中，仅淋巴结外侵犯和雌激素受体（ER）状态是 LRR 的显著预测因素（p = 0.003 和 0.0001），而内在亚型与 LRR 无显著关系（p = 0.57；危险比，2.9；95%置信区间，0.2-4.7）。
本研究结果表明，在评估 LRR 风险时，应考虑淋巴结外侵犯和 ER 状态阴性。内在亚型对 LRR 的预测能力小于经典病理指标。这些信息可能有助于计划接受乳房切除术的早期乳腺癌患者的 LRR 管理。
