title: Relative and disease-free survival for breast cancer in relation to subtype: a population-based study.
abstract: OBJECTIVE
  No population-based study has investigated breast cancer (BC) subtypes defined by including Ki67. The aim of this study was to evaluate the relative proportions of immunohistochemical subtypes and differences in relative and disease-free survival between subtypes, in relation to patient and other cancer characteristics in Italian BC patient.
  
  
  METHODS
  Information on estrogen, progesterone, human epidermal growth factor (HER2), Ki67, and relapses was obtained for 3,381 cases, sampled randomly and anonymously from cases diagnosed in 2003-2005 in nine Italian cancer registries. Relative excess risks (RERs) of death and risks of relapse 5 years after diagnosis were estimated.
  
  
  RESULTS
  Luminal A cancers were 42 % of the total, luminal B 27 %, luminal-HER2 14 %, triple-negative 11 %, and HER2-enriched 7 %. For non-metastatic (3,302) cases, 4 and 7 % developed locoregional and distant metastases, respectively. RERs of death and risks of relapse were significantly greater for all cancer subtypes than luminal A, particularly for triple-negative and HER2-enriched cancers, which were more frequent in women <40 years.
  
  
  CONCLUSIONS
  Our population-based findings confirm that subtype is an independent prognostic factor for BC. Triple-negative and HER2-enriched subtypes would benefit from the development and wide application, respectively, of targeted treatments, which would also improve survival for younger patients.
authors.affiliation: Analytical Epidemiology and Health Impact Unit, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian 1, 20133, Milan, Italy. pamela.minicozzi@istitutotumori.mi.it
authors.forename: Pamela
authors.initials: P
authors.lastname: Minicozzi
authors.forename: Francesca
authors.initials: F
authors.lastname: Bella
authors.forename: Angela
authors.initials: A
authors.lastname: Toss
authors.forename: Adriano
authors.initials: A
authors.lastname: Giacomin
authors.forename: Mario
authors.initials: M
authors.lastname: Fusco
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zarcone
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Fabio
authors.initials: F
authors.lastname: Falcini
authors.forename: Rosaria
authors.initials: R
authors.lastname: Cesaraccio
authors.forename: Giuseppa
authors.initials: G
authors.lastname: Candela
authors.forename: Francesco
authors.initials: F
authors.lastname: La Rosa
authors.forename: Massimo
authors.initials: M
authors.lastname: Federico
authors.forename: Milena
authors.initials: M
authors.lastname: Sant
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000145:classification / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology / Q000401:mortality* / Q000556:secondary; D018275:Carcinoma, Lobular / Q000453:epidemiology / Q000401:mortality* / Q000556:secondary; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D007558:Italy / Q000453:epidemiology; D008198:Lymph Nodes / Q000473:pathology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000145:classification / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D015996:Survival Rate; D055815:Young Adult
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone
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