Locoregional Recurrence and Survival Outcomes by Type of Local Therapy and Trastuzumab Use Among Women with Node-Negative, HER2-Positive Breast Cancer
Background While human epidermal growth factor receptor 2 (HER2) overexpression is an adverse breast cancer prognostic factor, it is unclear whether there are differences in outcomes between types of local treatment in this population. This retrospective study examined locoregional recurrence and su...
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Published in | Annals of surgical oncology Vol. 21; no. 11; pp. 3490 - 3496 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Boston
Springer US
01.10.2014
Springer Nature B.V |
Subjects | |
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Abstract | Background
While human epidermal growth factor receptor 2 (HER2) overexpression is an adverse breast cancer prognostic factor, it is unclear whether there are differences in outcomes between types of local treatment in this population. This retrospective study examined locoregional recurrence and survival in women with node-negative, HER2+ breast cancer treated with breast-conserving therapy (BCT) versus mastectomy.
Methods
Subjects were 748 patients with pT1–2, N0, M0 HER2+ breast cancer, treated with BCT (
n
= 422) or mastectomy (
n
= 326). Trastuzumab was used in 54 % of subjects. The 5-year Kaplan–Meier locoregional recurrence free survival (LRRFS), breast cancer specific survival (BCSS), and overall survival (OS) were compared between cohorts treated with BCT versus mastectomy. Subgroup analyses of LRR and survival were performed separately among patients treated with BCT or mastectomy to examine the effect of trastuzumab on outcomes in each group.
Results
Median follow-up was 4.4 years. Patients treated with mastectomy had higher proportions of grade 3 histology (69 vs 60 %,
p
= 0.004) and lower rates of hormone therapy (51 vs 64 %,
p
< 0.001) and trastuzumab therapy (50 vs 57 %,
p
= 0.04). The 5-year outcomes in women treated with BCT compared with mastectomy were: LRRFS 98.0 versus 98.3 % (
p
= 0.88), BCSS 97.2 versus 96.1 % (
p
= 0.70), and OS 95.5 versus 93.4 % (
p
= 0.19). Trastuzumab was associated with similar LRRFS and improved OS in both local treatment groups.
Conclusions
BCT is safe in the population of women with pT1–2, N0, HER2+ breast cancer, providing high rates of locoregional control and survival equivalent to mastectomy. Trastuzumab was associated with improved survival in both groups. |
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AbstractList | While human epidermal growth factor receptor 2 (HER2) overexpression is an adverse breast cancer prognostic factor, it is unclear whether there are differences in outcomes between types of local treatment in this population. This retrospective study examined locoregional recurrence and survival in women with node-negative, HER2+ breast cancer treated with breast-conserving therapy (BCT) versus mastectomy. Subjects were 748 patients with pT1-2, N0, M0 HER2+ breast cancer, treated with BCT (n = 422) or mastectomy (n = 326). Trastuzumab was used in 54 % of subjects. The 5-year Kaplan-Meier locoregional recurrence free survival (LRRFS), breast cancer specific survival (BCSS), and overall survival (OS) were compared between cohorts treated with BCT versus mastectomy. Subgroup analyses of LRR and survival were performed separately among patients treated with BCT or mastectomy to examine the effect of trastuzumab on outcomes in each group. Median follow-up was 4.4 years. Patients treated with mastectomy had higher proportions of grade 3 histology (69 vs 60 %, p = 0.004) and lower rates of hormone therapy (51 vs 64 %, p < 0.001) and trastuzumab therapy (50 vs 57 %, p = 0.04). The 5-year outcomes in women treated with BCT compared with mastectomy were: LRRFS 98.0 versus 98.3 % (p = 0.88), BCSS 97.2 versus 96.1 % (p = 0.70), and OS 95.5 versus 93.4 % (p = 0.19). Trastuzumab was associated with similar LRRFS and improved OS in both local treatment groups. BCT is safe in the population of women with pT1-2, N0, HER2+ breast cancer, providing high rates of locoregional control and survival equivalent to mastectomy. Trastuzumab was associated with improved survival in both groups.[PUBLICATION ABSTRACT] Background While human epidermal growth factor receptor 2 (HER2) overexpression is an adverse breast cancer prognostic factor, it is unclear whether there are differences in outcomes between types of local treatment in this population. This retrospective study examined locoregional recurrence and survival in women with node-negative, HER2+ breast cancer treated with breast-conserving therapy (BCT) versus mastectomy. Methods Subjects were 748 patients with pT1–2, N0, M0 HER2+ breast cancer, treated with BCT ( n = 422) or mastectomy ( n = 326). Trastuzumab was used in 54 % of subjects. The 5-year Kaplan–Meier locoregional recurrence free survival (LRRFS), breast cancer specific survival (BCSS), and overall survival (OS) were compared between cohorts treated with BCT versus mastectomy. Subgroup analyses of LRR and survival were performed separately among patients treated with BCT or mastectomy to examine the effect of trastuzumab on outcomes in each group. Results Median follow-up was 4.4 years. Patients treated with mastectomy had higher proportions of grade 3 histology (69 vs 60 %, p = 0.004) and lower rates of hormone therapy (51 vs 64 %, p < 0.001) and trastuzumab therapy (50 vs 57 %, p = 0.04). The 5-year outcomes in women treated with BCT compared with mastectomy were: LRRFS 98.0 versus 98.3 % ( p = 0.88), BCSS 97.2 versus 96.1 % ( p = 0.70), and OS 95.5 versus 93.4 % ( p = 0.19). Trastuzumab was associated with similar LRRFS and improved OS in both local treatment groups. Conclusions BCT is safe in the population of women with pT1–2, N0, HER2+ breast cancer, providing high rates of locoregional control and survival equivalent to mastectomy. Trastuzumab was associated with improved survival in both groups. While human epidermal growth factor receptor 2 (HER2) overexpression is an adverse breast cancer prognostic factor, it is unclear whether there are differences in outcomes between types of local treatment in this population. This retrospective study examined locoregional recurrence and survival in women with node-negative, HER2+ breast cancer treated with breast-conserving therapy (BCT) versus mastectomy. Subjects were 748 patients with pT1-2, N0, M0 HER2+ breast cancer, treated with BCT (n = 422) or mastectomy (n = 326). Trastuzumab was used in 54 % of subjects. The 5-year Kaplan-Meier locoregional recurrence free survival (LRRFS), breast cancer specific survival (BCSS), and overall survival (OS) were compared between cohorts treated with BCT versus mastectomy. Subgroup analyses of LRR and survival were performed separately among patients treated with BCT or mastectomy to examine the effect of trastuzumab on outcomes in each group. Median follow-up was 4.4 years. Patients treated with mastectomy had higher proportions of grade 3 histology (69 vs 60 %, p = 0.004) and lower rates of hormone therapy (51 vs 64 %, p < 0.001) and trastuzumab therapy (50 vs 57 %, p = 0.04). The 5-year outcomes in women treated with BCT compared with mastectomy were: LRRFS 98.0 versus 98.3 % (p = 0.88), BCSS 97.2 versus 96.1 % (p = 0.70), and OS 95.5 versus 93.4 % (p = 0.19). Trastuzumab was associated with similar LRRFS and improved OS in both local treatment groups. BCT is safe in the population of women with pT1-2, N0, HER2+ breast cancer, providing high rates of locoregional control and survival equivalent to mastectomy. Trastuzumab was associated with improved survival in both groups. |
Author | Alexander, Cheryl S. Peterson, David J. Sadek, Betro T. Raad, Rita Abi Taghian, Alphonse G. Wiksyk, Bradley Truong, Pauline T. Shenouda, Mina |
Author_xml | – sequence: 1 givenname: David J. surname: Peterson fullname: Peterson, David J. organization: Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver Island Centre – sequence: 2 givenname: Pauline T. surname: Truong fullname: Truong, Pauline T. email: ptruong@bccancer.bc.ca organization: Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver Island Centre, Breast Cancer Outcomes Unit, British Columbia Cancer Agency, Vancouver Island Centre, Department of Surgery, University of British Columbia – sequence: 3 givenname: Betro T. surname: Sadek fullname: Sadek, Betro T. organization: Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School – sequence: 4 givenname: Cheryl S. surname: Alexander fullname: Alexander, Cheryl S. organization: Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School – sequence: 5 givenname: Bradley surname: Wiksyk fullname: Wiksyk, Bradley organization: Department of Radiation Oncology, British Columbia Cancer Agency, Vancouver Island Centre – sequence: 6 givenname: Mina surname: Shenouda fullname: Shenouda, Mina organization: Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School – sequence: 7 givenname: Rita Abi surname: Raad fullname: Raad, Rita Abi organization: Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School – sequence: 8 givenname: Alphonse G. surname: Taghian fullname: Taghian, Alphonse G. organization: Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24841346$$D View this record in MEDLINE/PubMed |
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Keywords | Locoregional Control Breast Cancer Overall Survival Breast Cancer Specific Survival Trastuzumab |
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While human epidermal growth factor receptor 2 (HER2) overexpression is an adverse breast cancer prognostic factor, it is unclear whether there are... While human epidermal growth factor receptor 2 (HER2) overexpression is an adverse breast cancer prognostic factor, it is unclear whether there are differences... |
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SubjectTerms | Antibodies, Monoclonal, Humanized - therapeutic use Antineoplastic Agents - therapeutic use Breast Neoplasms - metabolism Breast Neoplasms - mortality Breast Neoplasms - pathology Breast Neoplasms - therapy Breast Oncology Combined Modality Therapy Female Follow-Up Studies Humans Immunoenzyme Techniques Lymph Nodes - pathology Mastectomy Mastectomy, Segmental Medicine Medicine & Public Health Middle Aged Neoplasm Grading Neoplasm Recurrence, Local - metabolism Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - therapy Neoplasm Staging Oncology Prognosis Receptor, ErbB-2 - metabolism Receptors, Estrogen - metabolism Receptors, Progesterone - metabolism Retrospective Studies Surgery Surgical Oncology Survival Rate Trastuzumab |
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Title | Locoregional Recurrence and Survival Outcomes by Type of Local Therapy and Trastuzumab Use Among Women with Node-Negative, HER2-Positive Breast Cancer |
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