The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland; Department of Surgery, Galway University Hospitals, Galway, Ireland.
Department of Surgery, Galway University Hospitals, Galway, Ireland.
Surg Oncol. 2021 Jun;37:101531. doi: 10.1016/j.suronc.2021.101531. Epub 2021 Jan 31.
The molecular era has identified four breast cancer subtypes. Luminal A breast cancer (LABC) is defined by estrogen-receptor positive (ER+), progesterone-receptor positive (PgR+) and human epidermal growth factor receptor-2 negative (HER2-) tumours; these cancers are the most common and carry favourable prognoses.
To describe clinicopathologic features, oncological outcome and relapse patterns in LABC.
Consecutive female patients diagnosed with ER/PgR+/HER2-, lymph node negative (LN-) breast cancer between 2005 and 2015 were included. Clinicopathological and recurrence data was recorded using descriptive statistics. Oncological outcome was determined using Kaplan-Meier and Cox-regression analyses.
Analysis was performed for 849 patients with median follow-up of 102.1 months. Mean disease-free (DFS) and overall survival (OS) were 85.8% and 91.8%. Seventy patients died during this study (8.2%), while 58 patients had recurrence; 7 had local recurrence (0.8%) and 51 had distant recurrence (DDR) (6.0%). Patients developing DDR were likely to be postmenopausal (P = 0.028), present symptomatically (P < 0.001) and have larger tumours (P < 0.001). The mean time to DDR was 65.7 months, with fatal recurrence occurring in 66.6% of patients with DDR (34/51). Systemic chemotherapy prescription did not influence DDR (P = 0.053). Age >65 (hazards ratio (HR):1.66, 95% Confidence Interval (CI):1.07-2.55, P = 0.022), presenting symptomatically (HR:2.28, 95%CI:1.21-4.29, P = 0.011) and tumour size >20 mm (HR:1.81, 95%CI:1.25-2.62, P = 0.002) predicted DFS, while age>65 (HR:2.60, 95%CI:1.49-4.53, P = 0.001) and being postmenopausal at diagnosis (HR:3.13, 95%CI:1.19-8.22, P = 0.020) predicted OS.
Our series demonstrated excellent survival outcomes for patients diagnosed with LN- LABC after almost a decade of follow-up. However, following DDR, fatal progression is often imminent.
分子时代已经确定了四种乳腺癌亚型。Luminal A 型乳腺癌（LABC）的定义是雌激素受体阳性（ER+）、孕激素受体阳性（PgR+）和人表皮生长因子受体 2 阴性（HER2-）肿瘤；这些癌症最常见，预后良好。
描述 LABC 的临床病理特征、肿瘤学结果和复发模式。
连续纳入 2005 年至 2015 年间诊断为 ER/PgR+/HER2-、淋巴结阴性（LN-）乳腺癌的女性患者。使用描述性统计记录临床病理和复发数据。使用 Kaplan-Meier 和 Cox 回归分析确定肿瘤学结果。
对 849 例中位随访时间为 102.1 个月的患者进行了分析。无病生存（DFS）和总生存（OS）的平均时间分别为 85.8%和 91.8%。研究期间有 70 名患者死亡（8.2%），58 名患者复发；7 名患者出现局部复发（0.8%），51 名患者出现远处复发（DDR）（6.0%）。出现 DDR 的患者更有可能绝经（P=0.028），表现为症状（P<0.001）和肿瘤更大（P<0.001）。DDR 的平均时间为 65.7 个月，51 例 DDR 中有 34 例（66.6%）发生致命性复发。全身化疗处方并未影响 DDR（P=0.053）。年龄>65 岁（危险比（HR）：1.66，95%置信区间（CI）：1.07-2.55，P=0.022）、出现症状（HR：2.28，95%CI：1.21-4.29，P=0.011）和肿瘤大小>20mm（HR：1.81，95%CI：1.25-2.62，P=0.002）预测 DFS，而年龄>65 岁（HR：2.60，95%CI：1.49-4.53，P=0.001）和绝经后诊断（HR：3.13，95%CI：1.19-8.22，P=0.020）预测 OS。
在近十年的随访后，我们的研究系列显示出 LN- LABC 患者出色的生存结果。然而，发生 DDR 后，致命进展往往迫在眉睫。
