Aim
To investigate the impact of biological subtypes in locoregional recurrence in Chinese breast cancer patients receiving postmastectomy radiotherapy (PMRT).
Methods and Materials
About 583 patients who received postmastectomy radiation between 2010 and 2012 were retrospectively analyzed. According to immunohistochemical staining profile, patients were classified into: Luminal Aālike, Luminal Bālike, HER2āpositive, and tripleānegative breast cancer (TNBC). Local and regional recurrence (LRR) cumulative incidences were calculated by competing risks methodology and the power of prognostic factors was examined by Gray's test and the test of Fine and Gray.
Results
The median followāup was 70.9Ā months. About 34 LRR events occurred. For Luminal A, Luminal B, HER2āpositive, and TNBC patients, the 5āyear LRR cumulative incidence rates were 1.57%, 4.09%, 10.74%, and 10.28%. Compared with Luminal A, HER2āpositive subtype and TNBC had a significant increased risk of LRR (HR was 5.034 and 5.188, respectively). In univariate analysis, predictive factors for higher LRR were HER2āpositive subtype (HRĀ =Ā 4.43, PĀ <Ā .05), TNBC (HRĀ =Ā 4.70, PĀ <Ā .05), and pN3 (HRĀ =Ā 5.83, PĀ <Ā .05). In the multivariate model, HER2āpositive subtype (HRĀ =Ā 5.034, PĀ <Ā .05), TNBC (HRĀ =Ā 5.188, PĀ <Ā .05), and pN3 (HRĀ =Ā 9.607, PĀ <Ā .01) were independent predictors of LRR. LRR without trastuzumab was similar to that of TNBC (without vs TNBC, 17.88% vs 10.28%, PĀ >Ā .05) in HER2āpositive subtype patients, while LRR with trastuzumab was approximate to Luminal A (with vs Luminal A, PĀ >Ā .05). Additionally, endocrine therapy also significantly reduced LRR incidence in the luminal subtype cohort (without vs with therapy, 6.25% vs 2.89%, HRĀ =Ā 0.365, PĀ <Ā .1).
Conclusions
Biological subtype was a prognostic factor of LRR in the PMRT setting among Chinese breast cancer patients.