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01-06-2012 | Review

Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype

Authors: Aoife J. Lowery, Malcolm R. Kell, Ronan W. Glynn, Michael J. Kerin, Karl J. Sweeney

Published in: Breast Cancer Research and Treatment | Issue 3/2012

Abstract

Molecular subtyping confirms that breast cancer comprises at least four genetically distinct entities based on the expression of specific genes including estrogen receptor (ER), progesterone receptor (PR), and HER2/neu receptor. The quantitative influence of subtype on ipsilateral locoregional recurrence (LRR) is unknown. The aim of this study was to systematically appraise the influence of breast cancer subtype on LRR following breast conserving therapy (BCT) and mastectomy. A comprehensive search for studies examining outcomes after BCT and/or mastectomy according to breast cancer subtype was performed using Medline and cross-referencing available data. Reviews of each study were conducted and data extracted to perform meta-analysis. Primary outcome was LRR related to breast cancer subtype. A total of 12,592 breast cancer patients who underwent either BCT (n = 7,174) or mastectomy (n = 5,418) were identified from 15 studies. Patients with luminal subtype tumors (ER/PR +ve) had a lower risk of LRR than both triple-negative (RR 0.38; 95% CI 0.23–0.61); and HER2/neu-overexpressing (RR 0.34; 95% CI 0.26–0.45) tumors following BCT. Luminal tumors were also less likely to develop LRR than HER2/neu-overexpressing (OR 0.69; 95% CI 0.54–0.89) or triple-negative tumors (OR 0.61; 95% CI 0.46–0.79) after mastectomy. HER2/neu-overexpressing tumors have increased risk of LRR compared to triple-negative tumors (RR 1.44; 95% CI 1.06–1.95) following BCT but there was no difference in LRR between HER2/neu-overexpressing and triple-negative tumors following mastectomy (RR 0.91; 95% CI 0.68–1.22). Luminal tumors exhibit the lowest rates of LRR. Patients with triple-negative and HER2/neu-overexpressing breast tumors are at increased risk of developing LRR following BCT or mastectomy. Breast cancer subtype should be taken into account when considering local control and identifies those at increased risk of LRR, who may benefit from more aggressive local treatment.

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Perou CM, Sørlie T, Eisen MB et al (2000) Molecular portraits of human breast tumours. Nature 406:747–752PubMedCrossRef

Sørlie T, Perou CM, Tibshirani R et al (2001) Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA 98:10869–10874PubMedCrossRef

Potti A, Dressman HK, Bild A et al (2006) Genomic signatures to guide the use of chemotherapeutics. Nat Med 12(11):1294–1300PubMedCrossRef

O’Brien KM, Cole SR, Tse CK et al (2010) Intrinsic breast tumor subtypes, race, and long-term survival in the Carolina Breast Cancer Study. Clin Cancer Res 16:6100–6110PubMedCrossRef

Spitale A, Mazzola P, Soldini D et al (2009) Breast cancer classification according to immunohistochemical markers: clinicopathologic features and short-term survival analysis in a population-based study from the South of Switzerland. Ann Oncol 20:628–635PubMedCrossRef

Clarke M, Collins R, Darby S et al (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366:2087–2106PubMed

Fisher B, Anderson S, Bryant J et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241PubMedCrossRef

Veronesi U, Cascinelli N, Mariani L et al (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347:1227–1232PubMedCrossRef

Soerjomataram I, Louwman MW, Ribot JG, Roukema JA, Coebergh JW (2008) An overview of prognostic factors for long term survivors of breast cancer. Breast Cancer Res Treat 107(3):309–330PubMedCrossRef

10.

Riley RD, Abrams KR, Sutton AJ et al (2003) Reporting of prognostic markers: current problems and development of guidelines for evidence-based practice in the future. Br J Cancer 88:1191–1198PubMedCrossRef

11.

Voduc KD, Cheang MC, Tyldesley S et al (2010) Breast cancer subtypes and the risk of local and regional relapse. J Clin Oncol 28:1684–1691PubMedCrossRef

12.

Arvold ND, Taghian AG, Niemierko A et al (2011) Age, breast cancer subtype approximation and local recurrence after breast conserving therapy. J Clin Oncol 29:3885–3891PubMedCrossRef

13.

Millar EK, Graham PH, O’Toole SA et al (2009) Prediction of local recurrence, distant metastases, and death after breast-conserving therapy in early-stage invasive breast cancer using a five-biomarker panel. J Clin Oncol 27:4701–4708PubMedCrossRef

14.

Wang SL, Li YX, Song YW et al (2010) Triple-negative or HER2-positive status predicts higher rates of locoregional recurrence in node-positive breast cancer patients after mastectomy. Int J Radiat Oncol Biol Phys 80(4):1095–1101PubMedCrossRef

15.

Straver ME, Rutgers EJ, Rodenhuis S et al (2010) The relevance of breast cancer subtypes in the outcome of neoadjuvant chemotherapy. Ann Surg Oncol 17:2411–2418PubMedCrossRef

16.

Gabos Z, Thoms J, Ghosh S et al (2010) The association between biological subtype and locoregional recurrence in newly diagnosed breast cancer. Breast Cancer Res Treat 124:187–194PubMedCrossRef

17.

Solin LJ, Hwang WT, Vapiwala N (2009) Outcome after breast conservation treatment with radiation for women with triple-negative early-stage invasive breast carcinoma. Clin Breast Cancer 9:96–100PubMedCrossRef

18.

Kyndi M, Sørensen FB, Knudsen H et al (2008) Estrogen receptor, progesterone receptor, HER-2, and response to postmastectomy radiotherapy in high-risk breast cancer: the Danish Breast Cancer Cooperative Group. J Clin Oncol 26:1419–1426PubMedCrossRef

19.

Freedman GM, Anderson PR, Li T et al (2009) Locoregional recurrence of triple-negative breast cancer after breast-conserving surgery and radiation. Cancer 115:946–951PubMedCrossRef

20.

Ihemelandu CU, Naab TJ, Mezghebe HM et al (2008) Treatment and survival outcome for molecular breast cancer subtypes in black women. Ann Surg 247:463–469PubMedCrossRef

21.

Haffty BG, Yang Q, Reiss M et al (2006) Locoregional relapse and distant metastasis in conservatively managed triple negative early-stage breast cancer. J Clin Oncol 24:5652–5657PubMedCrossRef

22.

Meyers MO, Klauber-Demore N, Ollila DW et al (2011) Impact of breast cancer molecular subtypes on locoregional recurrence in patients treated with neoadjuvant chemotherapy for locally advanced breast cancer. Ann Surg Oncol 18(10):2851–2857PubMedCrossRef

23.

Wong FY, Chin FK, Lee KA, Soong YL, Chua ET (2011) Hormone receptors and HER-2 status as surrogates for breast cancer molecular subtypes prognosticate for disease control in node negative Asian patients treated with breast conservation therapy. Ann Acad Med Singapore 40(2):90–97PubMed

24.

Siponen ET, Vaalavirta L, Joensuu H, Vironen J, Heikkilä P, Leidenius MH (2011) Ipsilateral breast recurrence after breast conserving surgery in patients with small (≤2 cm) breast cancer treated with modern adjuvant therapies. Eur J Surg Oncol 37(1):25–31PubMedCrossRef

25.

Mersin H, Gülben K, Berberoğlu U et al (2011) Prognostic factors affecting postmastectomy locoregional recurrence in patients with early breast cancer: are intrinsic subtypes effective? World J Surg 35(10):2196–2202PubMedCrossRef

26.

Haffty BG, Fischer D, Beinfield M et al (1991) Prognosis following local recurrence in the conservatively treated breast cancer patient. Int J Radiat Oncol Biol Phys 21:293–298PubMedCrossRef

27.

Haffty BG, Reiss M, Beinfield M et al (1996) Ipsilateral breast tumor recurrence as a predictor of distant disease: implications for systemic therapy at the time of local relapse. J Clin Oncol 14:52–57PubMed

28.

Giuliano AE, McCall L, Beitsch P et al (2010) Locoregional recurrence after sentinel lymph node dissection with or without axillary dissection in patients with sentinel lymph node metastases: the American College of Surgeons Oncology Group Z0011 randomized trial. Ann Surg 252:426–432PubMed

29.

Dunne C, Burke JP, Morrow M et al (2009) Effect of margin status on local recurrence after breast conservation and radiation therapy for ductal carcinoma in situ. J Clin Oncol 27:1615–1620PubMedCrossRef

30.

NSABP B-39, RTOG 0413 (2006) A randomized phase III study of conventional whole breast irradiation versus partial breast irradiation for women with stage 0, I, or II breast cancer. Clin Adv Hematol Oncol 4:719–721

31.

Livasy CA, Karaca G, Nanda R et al (2006) Phenotypic evaluation of the basal-like subtype of invasive breast carcinoma. Mod Pathol 19:264–271PubMedCrossRef

32.

Wolff AC, Hammond ME, Schwartz JN et al. (2007) American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. J Clin Oncol 25:118–145. http://www.asco.org/guidelines/her2

33.

Hammond ME, Hayes DF, Dowsett M et al. (2010) American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 28:2784–2795. http://www.asco.org/guidelines/erpr

34.

Foulkes WD, Smith IE, Reis-Filho JS (2010) Triple negative breast cancer. N Engl J Med 363:1938–1948PubMedCrossRef

35.

Brenton JD, Carey LA, Ahmed AA et al (2005) Molecular classification and molecular forecasting of breast cancer: ready for clinical application? J Clin Oncol 23:7350–7360PubMedCrossRef

36.

Billar JA, Dueck AC, Stucky CC et al (2010) Triple-negative breast cancers: unique clinical presentations and outcomes. Ann Surg Oncol 17(Suppl 3):384–390PubMedCrossRef

37.

Dent R, Trudeau M, Pritchard KI et al (2007) Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res 13:4429–4434PubMedCrossRef

38.

Recht A, Edge SB, Solin LJ et al (2001) Postmastectomy radiotherapy: clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol 19:1539–1569PubMed

39.

Truong PT, Olivotto IA, Kader HA et al (2005) Selecting breast cancer patients with T1–T2 tumors and one to three positive axillary nodes at high postmastectomy locoregional recurrence risk for adjuvant radiotherapy. Int J Radiat Oncol Biol Phys 61(5):1337–1347PubMedCrossRef

40.

Kunkler IH, Canney P, van Tienhoven G, Russell NS, MRC/EORTC (BIG 2-04) SUPREMO Trial Management Group (2008) Elucidating the role of chest wall irradiation in ‘intermediate-risk’ breast cancer: the MRC/EORTC SUPREMO trial. Clin Oncol (R Coll Radiol) 20:31–34

41.

Abdulkarim BS, Cuartero J, Hanson J et al (2011) Increased risk of locoregional recurrence for women with T1-2N0 triple-negative breast cancer treated with modified radical mastectomy without adjuvant radiation therapy compared with breast-conserving therapy. J Clin Oncol 29:2852–2858PubMedCrossRef

42.

(EBCTCG) Early Breast Cancer Trialists’ Collaborative Group et al (2005) Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: an overview of the randomised trials. Lancet 365:1687–1717CrossRef

43.

Hammond MEH, Hayes DF, Dowsett M et al (2010) American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 16:2784–2795CrossRef

44.

Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Davies C, Godwin J, Gray R, Clarke M, Cutter D, Darby S, McGale P, Pan HC, Taylor C, Wang YC, Dowsett M, Ingle J, Peto R (2011) Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 378(9793):771–784PubMed

45.

Slamon DJ, Clark GM, Wong SG et al (1987) Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science 235:177–182PubMedCrossRef

46.

Romond EH, Perez EA, Bryant J et al (2005) Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer. N Engl J Med 253:1673–1684CrossRef

47.

Clarke M, Stewart L, Pignon JP et al (1998) Individual patient data meta-analysis in cancer. Br J Cancer 77:2036–2044PubMedCrossRef

48.

Bartelink H, Horiot JC, Poortmans PM et al (2007) Impact of a higher radiation dose on local control and survival in breast-conserving therapy of early breast cancer: 10-year results of the randomized boost versus no boost EORTC 22881-10882 trial. J Clin Oncol 25:3259–3265PubMedCrossRef

Title: Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype
Authors: Aoife J. Lowery
Malcolm R. Kell
Ronan W. Glynn
Michael J. Kerin
Karl J. Sweeney
Publication date: 01-06-2012
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 3/2012
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-011-1891-6

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