Tumor aromatase expression as a prognostic factor for local control in young breast cancer patients after breast-conserving treatment.
BACKGROUND
We sought to determine whether the levels of expression of 17 candidate genes were associated with locoregional control after breast-conserving treatments of early-stage breast cancers in young, premenopausal women.


METHODS
Gene expression was measured by using RT-PCR in the breast tumors of a series of 53 young (younger than 40 years), premenopausal patients. All treatments consisted of primary breast-conserving surgery followed by whole-breast radiotherapy (+/- regional lymph nodes) with or without systemic treatments (chemotherapy +/- hormone therapy). The median follow-up was 10 years.


RESULTS
The 10-year locoregional control rate was 70% (95% CI, 57% to 87%). In univariate analysis, no clinical/pathologic prognostic factors were found to be significantly associated with decreased locoregional control. Expression of three genes was found to be significantly associated with an increased locoregional recurrence rate: low estrogen-receptor beta, low aromatase, and high GATA3. Two others were associated with only a trend (P < 0.10): low HER1 and SKP2. In multivariate analysis, only the absence of aromatase was significantly associated with an increased locoregional recurrence rate (P = 0.003; relative risk = 0.49; 95% CI 0.29 to 0.82).


CONCLUSIONS
Recent data give credit to the fact that breast cancer in young women is a distinct biologic entity driven by special oncogenic pathways. Our results highlight the role of estrogen-signaling pathways (mainly CYP19/aromatase, GATA3, and ER-beta) in the risk of locoregional recurrence of breast cancer in young women. Confirmation in larger prospective studies is needed.
Bollet
Marc A
MA
Department of Radiation Oncology, Institut Curie, 26 rue d'Ulm, 75248 Paris, France. marc.bollet@curie.net
Savignoni
Alexia
A
De Koning
Leanne
L
Tran-Perennou
Carine
C
Barbaroux
Catherine
C
Degeorges
Armelle
A
Sigal-Zafrani
Brigitte
B
Almouzni
Geneviève
G
Cottu
Paul
P
Salmon
Rémy
R
Servant
Nicolas
N
Fourquet
Alain
A
de Cremoux
Patricia
P
D000328:Adult; D000367:Age Factors; D001141:Aromatase / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000201:enzymology* / Q000235:genetics / Q000532:radiotherapy / Q000601:surgery; D002277:Carcinoma / Q000188:drug therapy / Q000201:enzymology* / Q000235:genetics / Q000532:radiotherapy / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D004967:Estrogens / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D056726:Genetic Association Studies; D006801:Humans; D015412:Mastectomy, Segmental; D009363:Neoplasm Proteins / Q000032:analysis*; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000235:genetics*; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000201:enzymology* / Q000235:genetics / Q000532:radiotherapy / Q000601:surgery; D017697:Premenopause; D011379:Prognosis; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D015398:Signal Transduction / Q000235:genetics; D055815:Young Adult
D014408:Biomarkers, Tumor; D004967:Estrogens; D009363:Neoplasm Proteins; D001141:Aromatase