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Gestational breast cancer: distinctive molecular and clinico-epidemiological features. GEICAM/2012-03 study

Date

08 Oct 2016

Session

Breast cancer, early

Presenters

Juan de la Haba

Citation

Annals of Oncology (2016) 27 (6): 43-67. 10.1093/annonc/mdw364

Authors

J. de la Haba1, A. Ruiz2, M. Pollan3, A. Prat4, F. Rojo5, M. Martin6, E. Alba Conejo7, J.A. Perez-Fidalgo8, J. Gavilá9, C. Morales10, B. Navarro11, A. Hernández-Blanquisett2, I. Porras10, A. Rodriguez-Lescure12, B. Jiménez-Rodríguez13, N. Martín14, L. Pérez-Ramos15, R. Caballero16, E. Carrasco17, A. Lluch-Hernandez18

Author affiliations

  • 1 Medical Oncology, Hospital Universitario Reina Sofía, 14004 - Cordoba/ES
  • 2 Medical Oncology, Fundación Instituto Valenciano de Oncología, 460009 - Valencia/ES
  • 3 Cancer Epidemiology, Instituto de Salud Carlos III (ISCIII), Madrid/ES
  • 4 Translational Genomics Group, Vall d’Hebron Institute of Oncology (VHIO),, 08035 - Barcelona/ES
  • 5 Pathology Department, University Hospital "Fundacion Jimenez Diaz", Madrid/ES
  • 6 Medical Oncology, 6Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Madrid/ES
  • 7 Medical Oncology, Hospital Universitario Regional y Virgen de la Victoria. IBIMA, Malaga/ES
  • 8 Oncology, Hospital Clinico Universitario de Valencia. Instituto de Investigación Sanitaria (INCLIVA), Valencia/ES
  • 9 Medical Oncology, Fundación Instituto Valenciano de Oncología, 46008 - Valencia/ES
  • 10 Medical Oncology, University Hospital Reina Sofia(Andalussian Health Service), IMIBIC, 14004 - Cordoba/ES
  • 11 Medical Oncology, 8Hospital Clinico Universitario de Valencia. Instituto de Investigación Sanitaria (INCLIVA), Valencia/ES
  • 12 Medical Oncology, Hospital General Universitario de Elche, Elche/ES
  • 13 Hospital Universitario Regional Y Virgen De La Victoria, Instituto de Investigacion Biomedica de Malaga (IBIMA), 29010 - Malaga/ES
  • 14 Translational Research, GEICAM Spanish Breast Cancer Group, Madrid/ES
  • 15 Statistics, GEICAM Spanish Breast Cancer Group, Madrid/ES
  • 16 Translational Research, GEICAM (Spanish Breast Cancer Research Group), Madrid/ES
  • 17 GEICAM (Spanish Breast Cancer Research Group), Madrid/ES
  • 18 Serv. Hematologia Y Oncologia Medica, 11Hospital Clínico Universitario de Valencia. INCLIVA Instituto de Investigación Sanitaria- Universitat de València, 46010 - Valencia/ES
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Abstract 3679

Background

Incidence of gestational breast cancer (GBC) (during pregnancy, lactation or first year postpartum) ranges from 6-15% of BC in the 20-44 subgroup age. GBC is associated with positive nodes, negative hormonal receptors (HR), triple negative and high grade tumors but little is known at molecular level. We explore specific genomic profiles and clinico-epidemiological features of GBC.

Methods

Expression of 105 genes was assessed in 50 evaluable tumors from 70 GBC Spanish patients using nCounter platform. The following signatures were assessed: 1) Intrinsic subtypes; 2) Proliferation (P) and Risk of Recurrence (ROR) scores; 3) Claudin-low and 4) Chemo-Endocrine Sensitivity Predictor (CESP). Genomic profile and clinico-epidemiological data were compared to equivalent nonGBC cohorts from GEICAM/9906 (n = 293) (NCT00129922), Málaga (n = 96) (Cancer Res, 2016 76; P3 07 15) and Alamo III project (n = 1473).

Results

Out of the 70 patients, 43% were diagnosed during pregnancy and 57% postpartum. The table reports patient and tumor characteristics:

n (%) GBC Alamo III 9906 Málaga
Mean age at diagnosis 35 37 37 37
Negative HR 30 (43) 330 (24) 33 (16) 27 (28)
T2-T4 51 (76) 787 (56) 176 (60) 84 (92)
Grade 3 38 (63) 479 (40) 121 (44) 38 (47)
Ki67 (≥20%) 33 (89) 209 (61) 46 (22) 60 (64)
Family history of BC 32 (47) 296 (25) - -
Mean age at first partum 31 26 - -

Intrinsic subtypes in GBC were 44% Basal-like, 22% Her2-enriched, 20% Luminal B and 14% Luminal A; no Claudin-low tumors were identified. Basal-like phenotype was enriched (44% vs 14%, p 

Conclusions

GBC differential biology is suggested by higher Basal-like and lower Luminal A rates, and absence of Claudin-low phenotype, correlating with worse survival and a more aggressive clinico-pathological profile confirmed by a higher ROR-P high rate and lower CESP score.

Legal entity responsible for the study

GEICAM Spanish Breast Cancer Group

Funding

Sociedad Española de Oncologia Medica (SEOM): Grant “SEOM Buckler”, Fundacion BBVA: Solidarity project: “BBVA Solidarity Territories“ Donations from two Associations of Breast Cancer Patients “Rosae” and “Santa Agueda”

Disclosure

A. Prat: Consulting Fees (advisory boards) Nanostring Technologies. All other authors have declared no conflicts of interest.

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