Department of Obstetrics and Gynecology, Otto-von-Guericke University, G.-Hauptmann Str. 35, 39108, Magdeburg, Germany.
Institute of Biometry and Medical Informatics, Otto-von-Guericke University, Magdeburg, Germany.
J Cancer Res Clin Oncol. 2018 Jul;144(7):1347-1355. doi: 10.1007/s00432-018-2644-2. Epub 2018 Apr 19.
To evaluate the pattern of recurrence of breast cancer according to its biological subtype in a large cohort of patients treated with therapy representative of current practice.
Patients treated between 2000 and 2016 with known biological subtype were eligible. Data were prospectively collected. Primary endpoint was the subtype-dependent pattern and time of recurrence. Loco-regional and distant site and time of recurrence were assessed.
Median follow-up time was 80.8 months. For 12,053 (82.5%) of 14,595 patients with primary non-metastatic invasive breast cancer a subtype classification was possible. The luminal A subtype had the highest 10-year survival followed by luminal B and luminal/HER2. The worst survival demonstrated HER2 enriched and TNBC. HER2 and TNBC had the highest rate of recurrence in the first 5 years, whereas the rate of recurrence for luminal A and luminal B tumors was initially low, but remained continuously even after 10 years of follow-up. Luminal A tumors demonstrated the lowest rate of distant metastases predominantly in bone. So did luminal B tumors. HER2 enriched subtype was characterized with increased rate of loco-regional recurrence and distant metastases in bone, liver and brain. Luminal/HER2 had pattern of relapse similar to HER2 enriched tumors, with exception of loco-regional relapse and brain metastases. TNBC had higher rate of lung, bone and brain metastases as well as loco-regional relapse.
Breast cancer subtypes are associated with different time and pattern of recurrence and it should be considered during treatment decision.
评估在接受具有当前实践代表性治疗的大型患者队列中，根据生物亚型乳腺癌复发的模式。
符合条件的患者为 2000 年至 2016 年期间接受过已知生物亚型治疗的患者。数据为前瞻性收集。主要终点为与亚型相关的复发模式和时间。评估局部区域和远处复发部位和时间。
中位随访时间为 80.8 个月。对于 14595 例原发性非转移性浸润性乳腺癌患者中的 12053 例（82.5%），可以进行亚型分类。 luminal A 亚型的 10 年生存率最高，其次是 luminal B 和 luminal/HER2。生存最差的是 HER2 富集型和三阴性乳腺癌。HER2 和三阴性乳腺癌在前 5 年复发率最高，而 luminal A 和 luminal B 肿瘤的复发率最初较低，但在 10 年随访后仍持续存在。luminal A 肿瘤主要在骨中表现出最低的远处转移率。luminal B 肿瘤也是如此。HER2 富集型的特点是局部区域复发和远处转移（骨、肝和脑）的发生率增加。luminal/HER2 与 HER2 富集型肿瘤的复发模式相似，但局部区域复发和脑转移除外。三阴性乳腺癌的肺、骨和脑转移以及局部区域复发率更高。
乳腺癌亚型与不同的复发时间和模式相关，在治疗决策中应考虑到这一点。
