Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands.
Department of Health Technology and Services Research, MIRA Institute for Biomedical Technology and Technical Medicine, University of Twente, Enschede, the Netherlands.
Int J Cancer. 2019 Jan 15;144(2):263-272. doi: 10.1002/ijc.31914. Epub 2018 Nov 28.
Here we report for the first time the relation between breast cancer subtypes and 10-year recurrence rates and mortality in the Netherlands. All operated women diagnosed with invasive non-metastatic breast cancer in 2005 in the Netherlands were included. Patients were classified into breast cancer subtypes according to ER, PR, HER2 status and grade: luminal A, luminal B, HER2 positive and triple negative. Percentages and hazards of recurrence were compared among subtypes. Adjusted 10-year overall (OS) and recurrence-free survival (RFS) were calculated using multivariable Cox regression. Of 8,062 patients, 4,482 (56%) were luminal A, 2,090 (26%) luminal B, 504 (6%) HER2 positive and 986 (12%) triple negative. Local recurrences (7.5%) and distant metastases (25.6%) occurred most often in HER2 positive disease and the least often in luminal A (3.7% and 9.5%, respectively). Regional recurrences were most often diagnosed in triple negative disease (5.2%), and the least often in luminal A (1.7%). HER2 positive and triple negative subtypes had the highest recurrence rates in the second year, while luminal A and B showed a more continuous pattern over time, with lobular tumours recurring more often. After adjustment for differences in baseline characteristics, triple negative disease showed worse 10-year OS and triple negative and HER2 positive disease had the lowest 10-year RFS. In the Netherlands, breast cancer subtypes are important predictors for 10-year recurrence rates. Knowledge on recurrence and survival rates according to these different subtypes, in combination with other prognostic factors, can support patient-tailored treatment and individualised follow-up.
在这里，我们首次报告了乳腺癌亚型与荷兰 10 年复发率和死亡率之间的关系。所有在 2005 年在荷兰被诊断为患有侵袭性非转移性乳腺癌的接受手术的女性均被纳入研究。根据 ER、PR、HER2 状态和分级，将患者分为乳腺癌亚型：luminal A、luminal B、HER2 阳性和三阴性。比较了各亚型之间的复发百分比和风险。使用多变量 Cox 回归计算调整后的 10 年总生存期（OS）和无复发生存率（RFS）。在 8062 名患者中，4482 名（56%）为 luminal A、2090 名（26%）为 luminal B、504 名（6%）为 HER2 阳性、986 名（12%）为三阴性。局部复发（7.5%）和远处转移（25.6%）最常见于 HER2 阳性疾病，luminal A 则最不常见（分别为 3.7%和 9.5%）。区域复发最常见于三阴性疾病（5.2%），luminal A 则最不常见（1.7%）。HER2 阳性和三阴性亚型在第二年的复发率最高，而 luminal A 和 B 则呈现出更连续的模式，小叶肿瘤的复发率更高。在调整了基线特征的差异后，三阴性疾病的 10 年 OS 较差，三阴性和 HER2 阳性疾病的 10 年 RFS 最低。在荷兰，乳腺癌亚型是 10 年复发率的重要预测因素。根据这些不同亚型的复发和生存率知识，结合其他预后因素，可以为患者提供个体化的治疗和随访。
