Treatment and survival outcome for molecular breast cancer subtypes in black women.
OBJECTIVE
To analyze whether the local-regional surgical treatments (breast-conserving therapy, mastectomy) resulted in different overall survival, distant metastasis-free survival, and locoregional recurrence-free survival rates for the various molecular breast cancer subtypes.


BACKGROUND
Molecular gene expression profiling has been proposed as a new classification and prognostication system for breast cancer. Current recommendation for local-regional treatment of breast cancer is based on traditional clinicopathologic variables.


METHODS
Retrospective analysis of 372 breast cancer cases with assessable immunohistochemical data for ER, PR, and Her-2/neu receptor status, diagnosed from 1998 to 2005. Molecular subtypes analyzed were luminal A, luminal B, basal like, and Her-2/neu.


RESULTS
No substantial difference was noted in overall survival, and locoregional recurrence rate between the local-regional treatment modalities as a function of the molecular breast cancer subtypes. The basal cell-like subtype was an independent predictor of a poorer overall survival (hazard ratio [HR] = 2.52, 95% confidence interval [CI] 1.28-4.97, P < 0.01) and a shorter distant metastasis-free survival time (HR = 3.61, 95% CI 1.27-10.2, P < 0.01), and showed a tendency toward statistical significance as an independent predictor of locoregional recurrence (HR = 3.57, 95% CI 0.93-13.6, P = 0.06).


CONCLUSIONS
The basal cell-like subtype is associated with a worse prognosis, a higher incidence of distant metastasis, and may be more prone to local recurrence when managed with breast-conserving therapy.
Ihemelandu
Chukwuemeka U
CU
Department of Surgery, Howard University College of Medicine, Washington, DC 20060, USA.
Naab
Tammey J
TJ
Mezghebe
Haile M
HM
Makambi
Kepher H
KH
Siram
Suryanarayana M
SM
Leffall
LaSalle D
LD
DeWitty
Robert L
RL
Frederick
Wayne A
WA
D000328:Adult; D000368:Aged; D044383:Black People; D001943:Breast Neoplasms / Q000235:genetics / Q000401:mortality* / Q000601:surgery*; D005260:Female; D015870:Gene Expression; D018734:Genes, erbB-2; D006801:Humans; D007150:Immunohistochemistry; D008408:Mastectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011960:Receptors, Estrogen / Q000032:analysis*; D011980:Receptors, Progesterone / Q000032:analysis*; D012189:Retrospective Studies
D011960:Receptors, Estrogen; D011980:Receptors, Progesterone