270P - Long-term overall survival (OS) and disease-free survival (DFS) according to PCR in breast cancers subtypes: luminal a and b, triple negative and HE...

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Breast Cancer, Early Stage
Pathology/Molecular Biology
Presenter Catherine Abrial
Authors C. Abrial1, Q. Wang-Lopez1, M. Mouret-Reynier2, P. Dubray-Longeras2, I. van Praagh-Doreau2, X. Durando2, P. Gimbergues3, J. Nabholtz2, F. Penault-Llorca4, P. Chollet2
  • 1Clinical Research, Centre Jean Perrin, 63011 - Clermont-Ferrand/FR
  • 2Oncology Department, Centre Jean Perrin, 63011 - Clermont-Ferrand/FR
  • 3Surgery Department, Centre Jean Perrin, 63011 - Clermont-Ferrand/FR
  • 4Dept. De Pathologie, Centre Jean Perrin, FR-63011 - Clermont-Ferrand CEDEX 1/FR

Abstract

Background

In breast cancer, positive Hormone Receptors (HR) constitute a favourable prognostic factor whereas HER-2 overexpression is an adverse prognostic factor associated with a more aggressive tumor. In a retrospective database of 282 breast cancer patients diagnosed from 1991 to 2006, we analysed the overall survival (OS) and the disease-free survival (DFS) of 4 phenotypes: HR-/HER-2- (triple negative, TN); HR + /Ki-67 < 20% (luminal A), HR + /Ki-67 > 20% or Her2+ (luminal B) and HER-2 overexpression (HER-2 + /HR-).

Patients and methods

Median diameter of the invasive tumour was 40 mm [10-130]. 231 (82%) patients had a canalar carcinoma. 33% of the tumours were grade III SBR. Patients received either an anthracycline-based chemotherapy (47%), a taxane-based chemotherapy (21%) or a combination of both (32%). The median number of NCT courses was 6 [1-8] followed by a surgery for 97.6%, a radiotherapy for 93%, an adjuvant chemotherapy for 20% and/or an hormonotherapy for 56%. Only 5 patients received adjuvant herceptin for 1 year. In the different subgroups, we had 123 luminal A tumors (44%), 67 luminal B tumours (24%), 21 Her2+ tumours (7%) and 71 TN tumours (25% of patients).

Results

According to tumour's phenotype, the pCR (Chevallier's classes 1 + 2) was: 3.3% for luminal A, 16.6%, for luminal B, 33.3% for Her2+ HR- and 26% for triple negative tumours. On 2 April 2012, the median follow-up was 148 months (range, 63- 252). We evaluated the OS and the DFS in the four subgroups, at 10 years. -For TN: OS and DFS were 58.5% and 56.2%. -For luminal A: OS and DFS were 76.1% and 64.7%. -For luminal B: OS and DFS were 81.7% and 72.4%. -For Her2 + HR- subgroup: OS and DFS were 64.5% and 56.4%. pCR is an objective method improvement after NCT, but it is variable among subsets, and may constitute an acquired prognostic factor. However, it was much smaller in hormonal-positive tumors subsets and may there not be an endpoint per se. We observed a significant improvement of DFS and OS for patients who reached a pCR only in TN breast cancer. However Her2 subset may be too small to reach significance here.

Conclusion

OS and DFS were better in luminal A and B subgroups. Conversely OS and DFS decreased for TN and Her2+ subtypes. When TN breast cancer patients reached a pCR, OS and DFS were significantly improved.

Disclosure

All authors have declared no conflicts of interest.