Lee Yoontaek, Kang Eunyoung, Lee Angela Soeun, Baek Hyunnam, Kim Eun-Kyu, Park So Yeon, Kim Jee Hyun, Kim Yu Jung, Kim Se Hyun, Kim In Ah, Eom Keun-Yong, Kim Sung-Won
Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea.
Breast Cancer Res Treat. 2015 May;151(1):183-90. doi: 10.1007/s10549-015-3390-7. Epub 2015 Apr 17.
The aim of this study was to evaluate the outcomes and patterns of recurrence in the different subtypes of breast cancer. We analyzed 1432 stage I-III breast cancer patients who had undergone surgery at Seoul National University Bundang Hospital between June 2003 and August 2011. Five subtypes were defined according to estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 (HER2), and Ki-67. Overall survival (OS) and breast cancer-free interval (BCFI) rates were estimated using the Kaplan-Meier method. Site-specific recurrence was estimated using Gray's test. The median follow-up period was 53 months. There were 22 local recurrences, 18 cases of contralateral breast cancer, 19 regional nodal recurrences, and 70 distant metastases. The 5-year BCFIs by subtype were luminal B-HER2 (+), 94.2 %; luminal A, 93.9 %; luminal B-HER2 (-), 91.4 %; HER2, 83.1 %; and triple-negative, 81.9 % (p < 0.001). Cases with the luminal A had a 5-year OS rate of 98.3 % that was the longest compared to those of cases with luminal B-HER2 (-), 95.8 %; luminal B-HER2 (+), 98.0 %; HER2, 90.8 %; and triple-negative, 89.9 % (p < 0.001). The triple-negative had a higher rate of local recurrence at the first site than others (p = 0.013). HER2 and triple-negative had higher rates of nodal recurrence at the first site than others (p < 0.001). The outcomes and patterns of site-specific recurrence in Korean breast cancer patients were different for each subtype. Defining recurrence patterns by breast cancer subtypes can help determine the appropriate method of surveillance and treatment.
本研究的目的是评估不同亚型乳腺癌的复发结局和模式。我们分析了2003年6月至2011年8月期间在首尔国立大学盆唐医院接受手术的1432例I-III期乳腺癌患者。根据雌激素受体、孕激素受体、人表皮生长因子受体2(HER2)和Ki-67定义了五种亚型。采用Kaplan-Meier方法估计总生存期(OS)和无乳腺癌间期(BCFI)率。使用Gray检验估计部位特异性复发情况。中位随访期为53个月。有22例局部复发、18例对侧乳腺癌、19例区域淋巴结复发和70例远处转移。各亚型的5年BCFI分别为:luminal B-HER2(+)型,94.2%;luminal A型,93.9%;luminal B-HER2(-)型,91.4%;HER2型,83.1%;三阴性型,81.9%(p<0.001)。luminal A型病例的5年OS率为98.3%,与luminal B-HER2(-)型病例的95.8%、luminal B-HER2(+)型病例的98.0%、HER2型病例的90.8%和三阴性型病例的89.9%相比是最长的(p<0.001)。三阴性型在首个部位的局部复发率高于其他类型(p=0.013)。HER2型和三阴性型在首个部位的淋巴结复发率高于其他类型(p<0.001)。韩国乳腺癌患者部位特异性复发的结局和模式在各亚型中有所不同。根据乳腺癌亚型定义复发模式有助于确定合适的监测和治疗方法。