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Breast Cancer Research
Published in: Breast Cancer Research 1/2021

Open Access 01-12-2021 | Breast Cancer | Research article

In modern times, how important are breast cancer stage, grade and receptor subtype for survival: a population-based cohort study

Authors: Anna L. V. Johansson, Cassia B. Trewin, Irma Fredriksson, Kristin V. Reinertsen, Hege Russnes, Giske Ursin

Published in: Breast Cancer Research | Issue 1/2021

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Abstract

Background

In breast cancer, immunohistochemistry (IHC) subtypes, together with grade and stage, are well-known independent predictors of breast cancer death. Given the immense changes in breast cancer treatment and survival over time, we used recent population-based data to test the combined influence of IHC subtypes, grade and stage on breast cancer death.

Methods

We identified 24,137 women with invasive breast cancer aged 20 to 74 between 2005 and 2015 in the database of the Cancer Registry of Norway. Kaplan-Meier curves, mortality rates and adjusted hazard ratios for breast cancer death were estimated by IHC subtypes, grade, tumour size and nodal status during 13 years of follow-up.

Results

Within all IHC subtypes, grade, tumour size and nodal status were independent predictors of breast cancer death. When combining all prognostic factors, the risk of death was 20- to 40-fold higher in the worst groups compared to the group with the smallest size, low grade and ER+PR+HER2− status. Among node-negative ER+HER2− tumours, larger size conferred a significantly increased breast cancer mortality. ER+PR−HER2− tumours of high grade and advanced stage showed particularly high breast cancer mortality similar to TNBC. When examining early versus late mortality, grade, size and nodal status explained most of the late (> 5 years) mortality among ER+ subtypes.

Conclusions

There is a wide range of risks of dying from breast cancer, also across small breast tumours of low/intermediate grade, and among node-negative tumours. Thus, even with modern breast cancer treatment, stage, grade and molecular subtype (reflected by IHC subtypes) matter for prognosis.
Appendix
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Metadata
Title
In modern times, how important are breast cancer stage, grade and receptor subtype for survival: a population-based cohort study
Authors
Anna L. V. Johansson
Cassia B. Trewin
Irma Fredriksson
Kristin V. Reinertsen
Hege Russnes
Giske Ursin
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 1/2021
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/s13058-021-01393-z

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