title: Breast cancer subtype approximations and loco-regional recurrence after immediate breast reconstruction.
abstract: BACKGROUND
  A small but significant proportion of patients with breast cancer (BC) will develop loco-regional recurrence (LRR) after immediate breast reconstruction (IBR). The LRR also varies according to breast cancer subtypes and clinicopathological features.
  
  
  METHODS
  We studied 1742 consecutive BC patients with IBR between 1997 and 2006. According to St Gallen conference consensus 2011, its BC approximations were applied to classify BC into five subtypes: estrogen receptor (ER) and/or progesterone receptor (PgR) positive, HER2 negative, and low Ki67 (<14%) [luminal A]; ER and/or PgR positive, HER2 negative and high Ki67(≥ 14%) [luminal B/HER2 negative]; ER and/or PgR positive, any Ki67 and HER2 positive [luminal B/HER2 positive]; ER negative, PgR negative and HER2 positive [HER2 positive/nonluminal]; and ER negative, PgR negative and HER2 negative [triple negative]. Cumulative incidences of LRR were compared across different subgroups by means of the Gray test. Multivariable Cox regression models were applied.
  
  
  RESULTS
  Median follow up time was 74 months (range 3-165). The cumulative incidence of LRR was 5.5% (121 events). The 5-year cumulative incidence of LRR was 2.5% for luminal A; 5.0% for luminal B/HER2 negative; 9.8% for luminal B/HER2 positive; 3.8% for HER2 non luminal; and 10.9% for triple negative. On multivariable analysis, tumor size (pT) >2 cm, body mass index (BMI) ≥ 25, triple negative and luminal B/HER2 positive subtypes were associated with increased risk of LRR.
  
  
  CONCLUSIONS
  Luminal B/HER2 positive, triple negative subtypes and BMI ≥ 25 are independent prognostic factors for risk of LRR after IBR.
authors: Division of Plastic Reconstruction Surgery, European Institute of Oncology, Via Ripamonti 435, 20141 Milano, Italy. mcassilha@ig.com.br
authors: M C
authors: MC
authors: Kneubil
authors: J
authors: J
authors: Brollo
authors: E
authors: E
authors: Botteri
authors: G
authors: G
authors: Curigliano
authors: N
authors: N
authors: Rotmensz
authors: A
authors: A
authors: Goldhirsch
authors: V
authors: V
authors: Lohsiriwat
authors: A
authors: A
authors: Manconi
authors: S
authors: S
authors: Martella
authors: B
authors: B
authors: Santillo
authors: J Y
authors: JY
authors: Petit
authors: M
authors: M
authors: Rietjens
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000737:chemistry / Q000209:etiology / Q000473:pathology* / Q000601:surgery* / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D019394:Ki-67 Antigen / Q000032:analysis; D008207:Lymphatic Metastasis; D016462:Mammaplasty; D008875:Middle Aged; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000209:etiology*; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications* / Q000378:metabolism; D016016:Proportional Hazards Models; D018714:Radiotherapy, Adjuvant; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human