Breast carcinoma subtypes show different patterns of metastatic behavior

Molnár, István; Molnár, Béla; Vízkeleti, Laura; Fekete, Krisztina; Tamás, Judit; Deák, Péter; Szundi, Csilla; Székely, Borbála; Moldvay, Judit; Vari-Kakas, Stefan; Szász, Marcell A.; Ács, Balázs; Kulka, Janina; Tőkés, Anna-Mária

doi:10.1007/s00428-017-2065-7

Cited by 69 publications

(72 citation statements)

References 44 publications

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“…The close link between these subtypes and different clinical behaviors of breast cancers as well as its different response to therapeutic chemotherapy regimens has also been identified (1,2). It is, thus, suggested a significant association between these molecular subtypes and known risk factors for breast cancer through different etiological pathways (3,4).…”

Section: Introductionmentioning

confidence: 91%

The Relationship of Reproductive Risk Factors and Histologic Patterns with Molecular Subtypes of Breast Cancer

et al. 2018

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Background: The close link between molecular subtypes and different histological types of breast cancer has recently been taken into consideration. Objectives: The present study aimed at evaluating the reproductive risk factors in relation to molecular subtypes and histological features of breast cancer in a large group of Iranian patients. Methods: This historical cohort study was conducted on 1988 women diagnosed as different subtypes of breast cancers recruited in 2011 to 2016 from cancer research center in Shahid Beheshti University of Medical Sciences, Iran. Data on molecular markers were obtained from hospital files obtaining originally from immunohistochemical staining technique. Based on the pathological reports in hospital recorded files, the histological patterns of the cancer was also determined. The patients were followed for 5 years to assess the 5-year survival and compared the survival across the different molecular subtypes. Results: The highest mean age was found for the group with HER2-overexpression and the lowest for those with luminal A (P = 0.045). The most and the least tumor size was revealed in triple negative group and luminal A group, respectively (P = 0.035). The mean number of lymph nodes involved in breast cancer was significantly higher in luminal B subtypes compared to luminal A and triple negative subtypes (P = 0.004). The tumor stages III-IV were found in 31.6% of patients with luminal A subtype, 42.2% in patients with luminal B, 34.3% in patients with HER2 overexpression, and 26.0% in those with triple negative subtype (P = 0.006). The histological patterns of the tumor were powerfully different in terms of the molecular subtypes of tumor so that luminal A subtype was found more in ILC pattern, luminal B subtype was found more in DCIS pattern, HER2-overexpression subtype was revealed more in DCIS pattern, and triple negative subtype was found more in IDC pattern. Based on the long-term survival analysis, 5-year survival was found to be 98.3% in luminal A group, 98.3% in luminal B group, 100% in HER2 overexpression, and 98.1% in triple negative with no difference between different molecular subtypes. The lowest 5-year survival was found in the patients aged higher than 30 years at first pregnancy and live birth with triple negative subtype (survival rate of 75.0%). The long-term survival was adversely associated with the tumor stage but independent to tumor molecular subtypes. Conclusions: Age at first live birth, tumor size, lymph node involvement, tumor stage, and histological pattern of breast cancer are linked to its molecular subtype. The lower long-term survival of breast cancer can be predicted by advanced age (especially in triple negative subtype) and by higher tumor stage independent to molecular subtype.

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Section: Introductionmentioning

confidence: 91%

The Relationship of Reproductive Risk Factors and Histologic Patterns with Molecular Subtypes of Breast Cancer

et al. 2018

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“…One of these factors is the breast cancer metastasis molecular subtype, based on the estrogen/progesterone receptor and the HER2 receptor amplification status. Recently, Molnár et al [31] showed that in case of recurrence, the best OS is associated with positive hormone receptor [HoR and negative human epidermal growth factor receptor 2 (HER2)] status of tumors (luminal A), followed by luminal B1 and B2 subtypes, defined as HoR+/HER2- with a Ki67 labeling index (LI) > 15% and HoR+/HER2+, respectively. Significant shorter OS was seen in patients with HoR-/HER2+ enhanced and HoR–/HER2– (triple negative cancer; TN) tumor subtypes [31].…”

Section: Characteristics Of Metastatic and Recurrent Breast Cancermentioning

confidence: 99%

“…Recently, Molnár et al [31] showed that in case of recurrence, the best OS is associated with positive hormone receptor [HoR and negative human epidermal growth factor receptor 2 (HER2)] status of tumors (luminal A), followed by luminal B1 and B2 subtypes, defined as HoR+/HER2- with a Ki67 labeling index (LI) > 15% and HoR+/HER2+, respectively. Significant shorter OS was seen in patients with HoR-/HER2+ enhanced and HoR–/HER2– (triple negative cancer; TN) tumor subtypes [31]. Additional prognostic factors regarding the OS of distant relapse are: (a) the time-point of relapse [8], (b) the localization of recurrent disease, and (c) the metastasis load at the time of diagnosis.…”

Section: Characteristics Of Metastatic and Recurrent Breast Cancermentioning

confidence: 99%

“…Different underlying characteristics have been observed, which help to explain this phenomenon. In cases of early metastasis (< 24 months after initial treatment), Ki67 LI and tumor grade were significantly higher and the size of the tumor and nodal involvement were significantly more advanced in the primary tumor compared to cases with later metastasis formation [31, 32]. Moreover, a shorter metastasis-free interval was associated with HoR cancer subtypes, i.e.…”

Section: Characteristics Of Metastatic and Recurrent Breast Cancermentioning

confidence: 99%

“…Moreover, a shorter metastasis-free interval was associated with HoR cancer subtypes, i.e. HER2+ or TN breast cancer, which has already been linked to a significant shorter OS regardless [31, 32]. Interestingly, the majority of patients with a short time to distant relapse and a more aggressive primary cancer phenotype were less than 50 years of age [32].…”

Section: Characteristics Of Metastatic and Recurrent Breast Cancermentioning

confidence: 99%

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Breast Cancer Recurrence Risk Assessment: Is Non-Invasive Monitoring an Option?

Schunkert

Zhao²,

Zänker

2018

Biomed Hub

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Background: Metastatic breast cancer (MBC) represents a life-threatening disease with a median survival time of 18–24 months that often can only be treated palliatively. The majority of women suffering from MBC are those who had been previously diagnosed with locally advanced disease and subsequently experienced cancer recurrence in the form of metastasis. However, according to guidelines, no systemic follow-up for monitoring purposes is recommended for these women. The purpose of this article is to review current methods of recurrent risk assessment as well as non-invasive monitoring options for women at risk for distant disease relapse and metastasis formation. Methods: We used PubMed and national guidelines, such as the National Comprehensive Cancer Network (NCCN), to find recently published studies on breast cancer recurrence risk assessment and systemic monitoring of breast cancer patients through non-invasive means. Results: The options for recurrence risk assessment of locally invasive breast cancer has improved due to diverse genetic tests, such as Oncotype DX, MammaPrint, the PAM50 (now known as the “Prosigna Test”) assay, EndoPredict (EP), and the Breast Cancer Index (BCI), which evaluate a women’s risk of relapse according to certain cancer-gene expression patterns. Different promising non-invasive urinary protein-based biomarkers with metastasis surveillance potential that have been identified are MMP-2, MMP-9, NGAL, and ADAM12. In particular, ααCTX, ββCTX, and NTX could help to monitor bone metastasis. Conclusion: In times of improved recurrence risk assessment of women with breast cancer, non-invasive biomarkers are urgently needed as potential monitoring options for women who have an increased risk of recurrence. Urine as a bioliquid of choice provides several advantages – it is non-invasive, can be obtained easily and frequently, and is economical. Promising biomarkers that could help to follow up women with increased recurrence risk have been identified. In order for them to be implemented in clinical usage and national guideline recommendations, further validation in larger independent cohorts will be needed.

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Risk factors and survival outcomes in patients with breast cancer and lung metastasis: a population‐based study

et al. 2018

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The risk factors for morbidity and mortality in breast cancer lung metastases (BCLM) patients still remain poorly identified. The aim of this study was to assess the incidence and survival of BCLM and associated risk factors. Patients with BCLM were identified from the Surveillance, Epidemiology, and End Results (SEER) database. Multivariate logistic regression analysis was used to determine the risk factors for BCLM. Predictors of factors associated with death were analyzed in Cox regression and Fine and Gray's test. Of the 11568 patients with stage IV breast cancer, 4213 (36.4%) had BCLM and 1214 (10.5%) had metastases confined to lungs. The median survival time for patients with BCLM was 21 months, and 15.5% of the patients were alive more than 3 years. The tumor subtype distribution was 45.3% HR−/HER2−, 12.2% HR+/HER2+, 7.8% HR−/HER2+, and 15.0% triple‐negative subtype. Compared with patients without BCLM, those with BCLM were more likely to be aged, female, black, higher tumor grade, HR−/HER2+, HR+/HER2+, and triple‐negative subtypes at diagnosis. Survival analysis showed that the aged, black race, HR−/HER2+, triple‐negative subtype, higher grade were the independent risk factor for BCLM patients’ survival, while HR+/HER2+ subtype, insured status, and married status suggested better prognosis. In conclusion, the incidence and prognosis of BCLM varied by tumor subtypes, age, and race. Elderly patients with HER2‐positive or triple‐negative tumors were more likely to have BCLM.

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Breast carcinoma subtypes show different patterns of metastatic behavior

Cited by 69 publications

References 44 publications

The Relationship of Reproductive Risk Factors and Histologic Patterns with Molecular Subtypes of Breast Cancer

The Relationship of Reproductive Risk Factors and Histologic Patterns with Molecular Subtypes of Breast Cancer

Breast Cancer Recurrence Risk Assessment: Is Non-Invasive Monitoring an Option?

Risk factors and survival outcomes in patients with breast cancer and lung metastasis: a population‐based study

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