380P - Conversion of the hormonal receptors on recurrent breast cancer patients

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Biomarkers
Breast Cancer, Metastatic
Presenter Kimihito Fujii
Citation Annals of Oncology (2014) 25 (suppl_4): iv116-iv136. 10.1093/annonc/mdu329
Authors K. Fujii, M. Goto, Y. Imai, T. Ando, R. Tetsuka, J. Kosaka, Y. Shiomi, M. Yoshida, S. Nakano, T. Imai, T. Fukutomi
  • Department Of Surgery, Aichi Medical University, 4801195 - Nagakute/JP

Abstract

Aim

When clinicians consider the treatment strategies for the recurrent breast cancer patients, the choice of treament is generally determined with the information of the pathological diagnosis of the primaries. However, the tumor phenotype is sometimes altered when it recurs. In this study, we compared the tumor characteristics among the primaries, metastatic lymph nodes and the recurrences, and assessed the correlation with the survival.

Methods

Seventy breast cancer patients whose diagnosis of the primaries and the metastases had been confirmed at Aichi Medical University Hospital were enrolled in this study. The comparative assessment of the lesions was performed on the following factors; the status of estrogen receptor (ER), progesterone receptor (PR), and Ki-67 index. Association with those factors were assessed and the survival was etimated.

Results

For ER, 19.8% of patients with the positive status in the primaries changed to the negative in the metastases (ER + /-) and the reverse conversion (from negative to positve; ER-/+) were confimed in 27.2% patients. In the similar fashion, PR + /- was recognized in 39.5% and PR-/+ in 31.2%. As for the metastatic lymph nodes, only 1 case of ER-positive in the primary converted to the negative, but 18.8% of PR-positive and 35.7% of PR-negative were altered to the each opposite receptor status. Ki-67 index increased significantly when the negative conversion occurred in the cases of the positive primaries. The overall survival was worsened significantly on the patients with negative alteration from the positive primaries. The hazard ratio for the survival was 0.29 (95% CI = 0.12-0.73) in the cases of ER + /+ vs. ER + /-, and 0.12 (95%CI = 0.03-0.43) in the cases of PR + /+ vs. PR + /-.

Conclusions

The receptor conversion that occur concomitantly with the recurrence of the breast cancer, was observed in about 20 to 40% recurrent cases. On metastasizing, the breast cancer acquired more aggressive nature, especially when its receptor status was altered from positive to negative. The tumor characteristics such as receptor status can be changed so easily that the treatment strategy have to be reconsidered for making an appropriate judgement on the next therapeutic way.

Disclosure

All authors have declared no conflicts of interest.