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01-08-2010 | Original Article

Patterns of relapse and metastatic spread in HER2-overexpressing breast cancer according to estrogen receptor status

Authors: Yeon Hee Park, Soohyeon Lee, Eun Yoon Cho, Yoon La Choi, Jeong Eon Lee, Seok Jin Nam, Jung-Hyun Yang, Jin Seok Ahn, Young-Hyuck Im

Published in: Cancer Chemotherapy and Pharmacology | Issue 3/2010

Abstract

Purpose

The primary aim of this study was to compare the relapse patterns of estrogen receptor (ER)-positive and ER-negative patients with HER2-overexpressing breast cancer. A secondary aim was to distinguish the preferential primary site of metastases in HER2-overexpressing breast cancer.

Methods

Out of 886 patients treated for metastatic breast cancer (MBC) between January 1995 and December 2006, 269 patients with HER2-positive tumors were identified. Of these, 198 patients with relapsed breast cancer following surgery were included in this study. Rates and patterns of relapse and metastatic spread in HER2+/ER+ and HER2+/ER− patients were analyzed. This analysis was evaluated by the validation patients’ cohort of our institute prospectively.

Results

Median relapse-free survival was longer in the HER2+/ER+ group than in the HER2+/ER− group (32.0 vs. 19.5 months, p = 0.0012). The peak of recurrence occurred at 12 months after surgery in the HER2+/ER− patients. The peak of relapse was later and the level was lower in the HER2+/ER+ patients (66 and 78 months following surgery) than in the HER2+/ER− patients (33 and 39 months following surgery, respectively). This result was reproduced by the validation cohort with great similarity. Young age [hazard ratio (HR) 1.59, p = 0.002], TNM stage 3 (HR 1.51, p = 0.005), and ER-negativity (HR 1.68, p < 0.0001) were identified as independent risk factors for relapse. Severe bone metastasis (HR 4.48, p = 0.028) and massive hepatic metastasis (HR 5.24, p = 0.043) were identified as independent risk factors for early relapse.

Conclusions

Our study shows that HER2-overexpressing breast cancer displays characteristic patterns of relapse and metastatic spread depending on ER status.

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Title: Patterns of relapse and metastatic spread in HER2-overexpressing breast cancer according to estrogen receptor status
Authors: Yeon Hee Park
Soohyeon Lee
Eun Yoon Cho
Yoon La Choi
Jeong Eon Lee
Seok Jin Nam
Jung-Hyun Yang
Jin Seok Ahn
Young-Hyuck Im
Publication date: 01-08-2010
Publisher: Springer-Verlag
Published in: Cancer Chemotherapy and Pharmacology / Issue 3/2010
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-009-1190-7

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Conclusions

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