Lundgren Christine, Bendahl Pär-Ola, Church Sarah E, Ekholm Maria, Fernö Mårten, Forsare Carina, Krüger Ute, Nordenskjöld Bo, Stål Olle, Rydén Lisa
Department of Oncology, Region Jönköping County, Jönköping, Sweden.
Department of Clinical Sciences Lund, Division of Oncology, Lund University, Lund, Sweden.
NPJ Breast Cancer. 2022 May 9;8(1):61. doi: 10.1038/s41523-022-00423-z.
PAM50 intrinsic subtyping and risk of recurrence (ROR) score are approved for risk profiling in postmenopausal women. We aimed to examine their long-term prognostic value in terms of breast cancer-free interval (BCFi) and overall survival (OS) (n = 437) in premenopausal women randomised to 2 years of tamoxifen versus no systemic treatment irrespective of hormone-receptor status. Intrinsic subtyping added independent prognostic information in patients with oestrogen receptor-positive/human epidermal growth factor 2-negative tumours for BCFi and OS after maximum follow-up (overall P-value 0.02 and 0.006, respectively) and those with high versus low ROR had worse prognosis (maximum follow-up: hazard ratio (HR): 1.70, P = 0.04). The prognostic information by ROR was similar regarding OS and in multivariable analysis. These results support that PAM50 subtyping and ROR score provide long-term prognostic information in premenopausal women. Moreover, tamoxifen reduced the incidence of breast cancer events only in patients with Luminal A tumours (0-10 years: HR: 0.41, HR: 1.19, P = 0.02).Trial registration: This trial is registered in the ISRCTN database, trial ID: ISRCTN12474687.
PAM50内在亚型分类和复发风险（ROR）评分已被批准用于绝经后女性的风险评估。我们旨在研究其在绝经前女性中的长期预后价值，这些女性被随机分配接受2年他莫昔芬治疗或不接受全身治疗，无论其激素受体状态如何（n = 437）。对于雌激素受体阳性/人表皮生长因子2阴性肿瘤患者，在最长随访期后，内在亚型分类为无乳腺癌间期（BCFi）和总生存期（OS）增加了独立的预后信息（总体P值分别为0.02和0.006），ROR高的患者与ROR低的患者相比预后更差（最长随访期：风险比（HR）：1.70，P = 0.04）。关于OS，ROR的预后信息在多变量分析中相似。这些结果支持PAM50亚型分类和ROR评分可为绝经前女性提供长期预后信息。此外，他莫昔芬仅降低了Luminal A型肿瘤患者的乳腺癌事件发生率（0至10年：HR：0.41，HR：1.19，P = 0.02）。试验注册：本试验已在ISRCTN数据库注册，试验编号：ISRCTN12474687。
