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01-06-2014 | Breast Oncology

Basal Subtype, as Approximated by Triple-Negative Phenotype, is Associated with Locoregional Recurrence in a Case–Control Study of Women with 0–3 Positive Lymph Nodes After Mastectomy

Authors: A. J. Khan, MD, S. A. Milgrom, MD, N. Barnard, MD, S. A. Higgins, MD, M. Moran, MD, Haseeba Shahzad, MD, S. Kim, PhD, S. Goyal, MD, F. Al-Faraj, MD, L. Kirstein, MD, T. Kearney, MD, B. G. Haffty, MD

Published in: Annals of Surgical Oncology | Issue 6/2014

Abstract

Purpose

Basal subtype, as approximated by the triple-negative phenotype (ER–PR–Her2−), has correlated with higher LRR in recent studies. Indications for postmastectomy RT (PMRT) in women with 0–3 positive lymph nodes remain unclear. We evaluated the importance of biologic subtype in a cohort of women with LRR after mastectomy.

Methods

We identified 22 women with 0–3 positive lymph nodes at our institution who were initially treated with mastectomy (without post-mastectomy radiation), suffered LRRs, and had paraffin-embedded tissue blocks from the primary mastectomy specimen available for staining. None of these women received PMRT. We case–control matched these to 29 women with 0–3 positive nodes who had mastectomy (no PMRT) and remained without evidence of disease at last follow-up and had available primary specimens for processing. We matched controls for age (±3 years) and follow-up duration (<5 year vs. more). Paraffin-embedded specimens were used to construct a triple-redundant tissue microarray. We used conditional logistic regressions to study the association between each predictor and LRR. Results were summarized based on odds ratio (OR).

Results

On univariate analysis, ER+, PR+, or the combination was strongly associated with lower odds of LRR. Basal subtype, as approximated by ER–PR–Her2− (TN), was associated with higher LRR (OR 8.5, p = 0.048). Use of chemotherapy also was associated with lower LRR (OR 0.126, p = 0.0073).

Conclusions

Our data are concordant with reports from others demonstrating that TN phenotype is associated with higher LRR and can be considered along with other predictors of LRR when selecting women for PMRT.

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Title: Basal Subtype, as Approximated by Triple-Negative Phenotype, is Associated with Locoregional Recurrence in a Case–Control Study of Women with 0–3 Positive Lymph Nodes After Mastectomy
Authors: A. J. Khan, MD
S. A. Milgrom, MD
N. Barnard, MD
S. A. Higgins, MD
M. Moran, MD
Haseeba Shahzad, MD
S. Kim, PhD
S. Goyal, MD
F. Al-Faraj, MD
L. Kirstein, MD
T. Kearney, MD
B. G. Haffty, MD
Publication date: 01-06-2014
Publisher: Springer US
Published in: Annals of Surgical Oncology / Issue 6/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-014-3512-1

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Basal Subtype, as Approximated by Triple-Negative Phenotype, is Associated with Locoregional Recurrence in a Case–Control Study of Women with 0–3 Positive Lymph Nodes After Mastectomy

Abstract

Purpose

Methods

Results

Conclusions

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Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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