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2015 ; 4
(ä): 528
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Comprehensive prognostic analysis in breast cancer integrating clinical, tumoral,
micro-environmental and immunohistochemical criteria
#MMPMID26405647
de Mascarel I
; Debled M
; Brouste V
; Mauriac L
; Sierankowski G
; Velasco V
; Croce S
; Chibon F
; Boudeau J
; Debant A
; MacGrogan G
Springerplus
2015[]; 4
(ä): 528
PMID26405647
show ga
Significant morphological, clinical and biological prognostic factors vary
according to molecular subtypes of breast tumors, yet comprehensive analysis of
such factors linked to survival in each group is lacking. Clinicopathological and
micro-environmental criteria, estrogen (ER), progesterone (PR) receptors, HER2,
Ki67, basal markers, CD24, CD44, ALDH1, BCL2, E-Cadherin and Trio were assessed
in 1070 primary operable breast cancers from a single center according to five
main molecular subtypes and associations with distant metastasis-free survival
(DMFS) were examined. There were 682 (64 %) luminal A (LA), 166 (16 %) Luminal B
HER2 negative (LBH-), 47 (4 %) Luminal B HER2 positive (LBH+), 108 (10 %) triple
negative (TN) and 67 (6 %) HER2-enriched tumors (H2+). Median follow-up was
13.7 years. At 5 years, DMFS in LA (90 %) was better than in LBH- (80.9 %),
hazard ratio (HR) = 2.22 [1.44-3.43] P < 0.001; LBH+ (74.5 %), HR = 3.14
[1.69-5.84] P < 0.001, TN (71.5 %) HR = 3.63 [2.34-5.63], P < 0.001; and H2+
(65.2 %), HR = 4.69 [2.90-7.59], P < 0.001. In multivariable analysis, factors
associated with shorter DMFS varied according to molecular subtype, with tumor
size being associated with shorter DMFS in the LBH-, LBH+ and TN groups and the
Rho GEF Trio and BCL2 phenotypes in TN tumors only. These findings help to define
new clinicophenotypic models and to identify new therapeutic strategies in the
specific molecular subgroups.