Taskaynatan Halil, Kucukzeybek Yuksel, Alacacioglu Ahmet, Yildiz Yasar, Salman Tarik, Oflazoglu Utku, Varol Umut, Bolat Kucukzeybek Betul, Kemal Atahan Murat, Oktay Tarhan Mustafa
Department of Medical Oncology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey.
J BUON. 2018 Jul-Aug;23(4):877-882.
Patients with breast cancer with Luminal-A subtype have a better prognosis but poor chemotherapy response. Chemotherapy is controversial in lymph node-positive patients with Luminal-A subtype. In this retrospective study, we aimed to evaluate the efficacy and benefit of chemotherapy in the Luminal A-like subtype of breast cancer.
Patients diagnosed with breast cancer within 2006 and 2011 were retrospectively evaluated. Patients with pathologically confirmed Luminal A-like breast cancer were analyzed , and were divided in those receiving taxane-based adjuvant chemotherapy and those who did not.
A total of 136 patients with Luminal-A type were included in the study. The 10-year cumulative disease-free survival (DFS) was 85.6 vs 96.7% (p=0.230) for the chemotherapy and non-chemotherapy groups, and overall survival (OS) was 88.6 vs 100%, respectively (p=0.242). The 10-year cumulative DFS was 80 vs 98.1% for the taxane-based chemotherapy group and taxane-free chemotherapy group (p=0.501), while the OS was 87.5 vs 95.2%, respectively (p=0.391). There was a positive correlation between relapse status and lymph node involvement in the multivariate analysis (p=0.031).
Adjuvant chemotherapy in Luminal-A showed no significant difference for DFS and OS. Taxane-based chemotherapy did not demonstrate any benefit for OS and DFS with relatively more advanced stage and lymph node involvement. We believe that adjuvant chemotherapy plays a minor role in a significant proportion of Luminal-A subtype of breast cancer.
Luminal-A亚型乳腺癌患者预后较好，但化疗反应不佳。Luminal-A亚型淋巴结阳性患者的化疗存在争议。在这项回顾性研究中，我们旨在评估化疗在Luminal A样亚型乳腺癌中的疗效和益处。
对2006年至2011年期间诊断为乳腺癌的患者进行回顾性评估。分析病理确诊为Luminal A样乳腺癌的患者，并将其分为接受紫杉烷类辅助化疗的患者和未接受化疗的患者。
本研究共纳入136例Luminal-A型患者。化疗组和非化疗组的10年累积无病生存率（DFS）分别为85.6%和96.7%（p=0.230），总生存率（OS）分别为88.6%和100%（p=0.242）。紫杉烷类化疗组和非紫杉烷类化疗组的10年累积DFS分别为80%和98.1%（p=0.501），而OS分别为87.5%和95.2%（p=0.391）。多因素分析显示复发状态与淋巴结受累之间存在正相关（p=0.031）。
Luminal-A型患者辅助化疗的DFS和OS无显著差异。对于分期相对较晚且有淋巴结受累的患者，紫杉烷类化疗在OS和DFS方面未显示出任何益处。我们认为辅助化疗在相当一部分Luminal-A亚型乳腺癌中作用较小。
