Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Cancer
Published in: BMC Cancer 1/2009

Open Access 01-12-2009 | Research article

Site-specific relapse pattern of the triple negative tumors in Chinese breast cancer patients

Authors: Yanping Lin, Wenjin Yin, Tingting Yan, Liheng Zhou, Genhong Di, Jiong Wu, Zhenzhou Shen, Zhimin Shao, Jinsong Lu

Published in: BMC Cancer | Issue 1/2009

Login to get access

Abstract

Background

It has been reported that triple negative phenotype is characterized by aggressive clinical history in Western breast cancer patients, however its pattern of metastatic spread had never been reported in the Chinese population. Considering racial disparities, we sought to analyze the spread pattern for different sites of first recurrence in Chinese triple negative breast cancers.

Methods

A retrospective study of 1662 patients was carried out from a large database of breast cancer patients undergoing surgery between January 1, 2000 and March 31, 2004 at the Cancer Hospital, Fudan University, Shanghai, China. Survival curves were generated using the Kaplan-Meier method and annual relapse hazards were estimated by the hazard function.

Results

We found a statistically significant difference in relapse-free survival (RFS) for locoregional and visceral recurrence (P = 0.007 and P = 0.025, respectively) among the triple negative, ERBB2+ and HR+/ERBB2- subgroups in univariate analysis. In the multivariate Cox proportional hazards regression analysis, RFS for either locoregional or visceral relapse in the triple negative category was inferior to that in HR+/ERBB2- patients (P = 0.027 and P = 0.005, respectively), but comparable to that in ERBB2+ women (both P > 0.05). Furthermore, the early relapse peak appeared later in the triple negative group than that in the ERBB2+ counterpart for both locoregional and visceral relapse. On the other hand, when compared with triple negative breast cancers, a significantly lower risk of developing bone relapse was discerned for ERBB2+ women (P = 0.048; HR = 0.384, 95% CI 0.148-0.991), with the borderline significance for HR+/ERBB2- breast cancers (P = 0.058; HR = 0.479, 95% CI 0.224-1.025). In terms of bone metastasis, the hazard rate remained higher for the triple negative category than that for the ERBB2+ subtype.

Conclusion

Based on the site-specific spread pattern in different subgroups, the triple negative category of breast cancers in the Chinese population exhibits a different pattern of relapse, which indicates that different organotropism may be due to the different intrinsic subtypes. A better knowledge of the triple negative category is warranted for efficacious systemic regimens to decrease and/or delay the relapse hazard.
Appendix
Available only for authorised users
Literature
1.
Sorlie T, Tibshirani R, Parker J, Hastie T, Marron JS, Nobel A, Deng S, Johnsen H, Pesich R, Geisler S, et al: Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci USA. 2003, 100 (14): 8418-8423. 10.1073/pnas.0932692100.CrossRefPubMedPubMedCentral
2.
Cleator S, Heller W, Coombes RC: Triple-negative breast cancer: therapeutic options. Lancet Oncol. 2007, 8: 235-244. 10.1016/S1470-2045(07)70074-8.CrossRefPubMed
3.
Carey LA, Perou CM, Livasy CA, Dressler LG, Cowan D, Conway K, Karaca G, Troester MA, Tse CK, Edmiston S, et al: Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA. 2006, 295 (21): 2492-2502. 10.1001/jama.295.21.2492.CrossRefPubMed
4.
Yin WJ, Lu JS, Di GH, Lin YP, Zhou LH, Liu GY, Wu J, Shen KW, Han QX, Shen ZZ, et al: Clinicopathological features of the triple-negative tumors in Chinese breast cancer patients. Breast Cancer Res Treat. 2009, 115 (2): 325-333. 10.1007/s10549-008-0096-0.CrossRefPubMed
5.
Kurebayashi J, Moriya T, Ishida T, Hirakawa H, Kurosumi M, Akiyama F, Kinoshita T, Takei H, Takahashi K, Ikeda M, et al: The prevalence of intrinsic subtypes and prognosis in breast cancer patients of different races. Breast. 2007, 16 (Suppl 2): S72-77. 10.1016/j.breast.2007.07.017.CrossRefPubMed
6.
Olopade OI, Ikpatt FO, Dignam JJ, Khramtsov A, Tetriakova M, Grushko T, Fackenthal J, Nanda R, Ndoma-Egba R, CM P: "Intrinsic Gene Expression" subtypes correlated with grade and morphometric parameters reveal a high proportion of aggressive basal-like tumors among black women of African ancestry. American Society of Clinical Oncology Annual Meeting: 5-8 June 2004; New Orleans, Louisiana, USA. 2004
7.
Carey LA, Dees EC, Sawyer L, Gatti L, Moore DT, Collichio F, Ollila DW, Sartor CI, Graham ML, CM P: The triple negative paradox: primary tumor chemosensitivity of breast cancer subtypes. Clin Cancer Res. 2004, 15: 2329-2334.
8.
Nielsen TO, Hsu FD, Jensen K, Cheang M, Karaca G, Hu Z, Hernandez-Boussard T, Livasy C, Cowan D, Dressler L, et al: Immunohistochemical and clinical characterization of the basal-like subtype of invasive breast carcinoma. Clin Cancer Res. 2004, 10 (16): 5367-5374. 10.1158/1078-0432.CCR-04-0220.CrossRefPubMed
9.
Sorlie T, Perou CM, Tibshirani R, Aas T, Geisler S, Johnsen H, Hastie T, Eisen MB, Rijn van de M, Jeffrey SS, et al: Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA. 2001, 98 (19): 10869-10874. 10.1073/pnas.191367098.CrossRefPubMedPubMedCentral
10.
Bauer KR, Brown M, Cress RD, Parise CA, Caggiano V: Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: a population-based study from the California cancer Registry. Cancer. 2007, 109 (9): 1721-1728. 10.1002/cncr.22618.CrossRefPubMed
11.
Dent R, Trudeau M, Pritchard KI, Hanna WM, Kahn HK, Sawka CA, Lickley LA, Rawlinson E, Sun P, Narod SA: Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res. 2007, 13 (15 Pt 1): 4429-4434. 10.1158/1078-0432.CCR-06-3045.CrossRefPubMed
12.
Banerjee S, Reis-Filho JS, Ashley S, Steele D, Ashworth A, Lakhani SR, Smith IE: Basal-like breast carcinomas: clinical outcome and response to chemotherapy. J Clin Pathol. 2006, 59 (7): 729-735. 10.1136/jcp.2005.033043.CrossRefPubMedPubMedCentral
13.
Rodriguez-Pinilla SM, Sarrio D, Honrado E, Hardisson D, Calero F, Benitez J, Palacios J: Prognostic significance of basal-like phenotype and fascin expression in node-negative invasive breast carcinomas. Clin Cancer Res. 2006, 12 (5): 1533-1539. 10.1158/1078-0432.CCR-05-2281.CrossRefPubMed
14.
Chang BW, Decker RH, Haffy BG, et al: Incidence of brain metastases in early-stage triple negative breast cancer patients. the 49th American Society for Therapeutic Radiology and Oncology (ASTRO) Annual Meeting: 28 October-1 November 2007; Los Angeles, California, USA. 2007
15.
Haffty BG, Yang Q, Reiss M, Kearney T, Higgins SA, Weidhaas J, Harris L, Hait W, Toppmeyer D: Locoregional relapse and distant metastasis in conservatively managed triple negative early-stage breast cancer. J Clin Oncol. 2006, 24 (36): 5652-5657. 10.1200/JCO.2006.06.5664.CrossRefPubMed
16.
Joensuu H, Isola J, Lundin M, Salminen T, Holli K, Kataja V, Pylkkanen L, Turpeenniemi-Hujanen T, von Smitten K, Lundin J: Amplification of erbB2 and erbB2 expression are superior to estrogen receptor status as risk factors for distant recurrence in pT1N0M0 breast cancer: a nationwide population-based study. Clin Cancer Res. 2003, 9 (3): 923-930.PubMed
17.
Jatoi I, Tsimelzon A, Weiss H, Clark GM, Hilsenbeck SG: Hazard rates of recurrence following diagnosis of primary breast cancer. Breast Cancer Res Treat. 2005, 89 (2): 173-178. 10.1007/s10549-004-1722-0.CrossRefPubMed
18.
McShane LM, Altman DG, Sauerbrei W, Taube SE, Gion M, Clark GM: REporting recommendations for tumor MARKer prognostic studies (REMARK). Breast Cancer Res Treat. 2006, 100 (2): 229-235. 10.1007/s10549-006-9242-8.CrossRefPubMed
19.
Gruber G, Bonetti M, Nasi ML, Price KN, Castiglione-Gertsch M, Rudenstam CM, Holmberg SB, Lindtner J, Golouh R, Collins J, et al: Prognostic value of extracapsular tumor spread for locoregional control in premenopausal patients with node-positive breast cancer treated with classical cyclophosphamide, methotrexate, and fluorouracil: long-term observations from International Breast Cancer Study Group Trial VI. J Clin Oncol. 2005, 23 (28): 7089-7097. 10.1200/JCO.2005.08.123.CrossRefPubMed
20.
Tan DS, Marchio C, Jones RL, Savage K, Smith IE, Dowsett M, Reis-Filho JS: Triple negative breast cancer: molecular profiling and prognostic impact in adjuvant anthracycline-treated patients. Breast Cancer Res Treat. 2008, 111 (1): 27-44. 10.1007/s10549-007-9756-8.CrossRefPubMed
21.
Dent R, Hanna WM, Trudeau M, Rawlinson E, Sun P, Narod SA: Pattern of metastatic spread in triple-negative breast cancer. Breast Cancer Res Treat. 2009, 115 (2): 423-428. 10.1007/s10549-008-0086-2.CrossRefPubMed
22.
23.
Solomayer EF, Diel IJ, Meyberg GC, Gollan C, G B: Metastatic breast cancer: clinical course, prognosis and therapy related to the first site of metastasis. Breast Cancer Res Treat. 2000, 59 (3): 271-278. 10.1023/A:1006308619659.CrossRefPubMed
24.
Kallioniemi OP, Holli K, Visakorpi T, Koivula T, Helin HH, JJ I: Association of c-erbB-2 protein over-expression with high rate of cell proliferation, increased risk of visceral metastasis and poor long-term survival in breast cancer. Int J Cancer. 1991, 49 (5): 650-655. 10.1002/ijc.2910490504.CrossRefPubMed
25.
Arpino G, Weiss H, Lee AV, Schiff R, De Placido S, Osborne CK, Elledge RM: Estrogen receptor-positive, progesterone receptor-negative breast cancer: association with growth factor receptor expression and tamoxifen resistance. J Natl Cancer Inst. 2005, 97 (17): 1254-1261.CrossRefPubMed
Metadata
Title
Site-specific relapse pattern of the triple negative tumors in Chinese breast cancer patients
Authors
Yanping Lin
Wenjin Yin
Tingting Yan
Liheng Zhou
Genhong Di
Jiong Wu
Zhenzhou Shen
Zhimin Shao
Jinsong Lu
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2009
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-9-342

Other articles of this Issue 1/2009

BMC Cancer 1/2009 Go to the issue

Research article

Pediatric differentiated thyroid carcinoma in stage I: risk factor analysis for disease free survival

Research article

Establishment of canine hemangiosarcoma xenograft models expressing endothelial growth factors, their receptors, and angiogenesis-associated homeobox genes

Research article

The potential biomarkers in predicting pathologic response of breast cancer to three different chemotherapy regimens: a case control study

Case report

Case report: Malignant teratoma of the uterine corpus

Research article

Malignant transformation of oral potentially malignant disorders in males: a retrospective cohort study

Research article

XPD codon 312 and 751 polymorphisms, and AFB1 exposure, and hepatocellular carcinoma risk
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine
Image Credits