title: Are breast cancer molecular classes predictive of survival in patients with long follow-up?
abstract: In this study we investigate the clinical outcomes of 305 breast cancer (BC) patients, aged 55 years or younger, with long follow-up and according to intrinsic subtypes. The cohort included 151 lymph node negative (LN-) and 154 lymph node positive (LN+) patients. Luminal A tumors were mainly LN-, well differentiated, and of stage I; among them AR was an indicator of good prognosis. Luminal B and HER2 positive nonluminal cancers showed higher tumor grade and nodal metastases as well as higher proliferation status and stage. Among luminal tumors, those PR positive and vimentin negative showed a longer survival. HER2-positive nonluminal and TN patients showed a poorer outcome, with BC-specific death mostly occurring within 5 and 10 years. Only luminal tumor patients underwent BC death over 10 years. When patients were divided in to LN- and LN+ no differences in survival were observed in the luminal subgroups. LN- patients have good survival even after 20 years of follow-up (about 75%), while for LN+ patients survival at 20 years (around 40%) was comparable to HER2-positive nonluminal and TN groups. In conclusion, in our experience ER-positive breast tumors are better divided by classical clinical stage than molecular classification, and they need longer clinical follow-up especially in cases with lymph node involvement.
authors.affiliation: Department of Medical Sciences, Cattinara Hospital, Strada di Fiume 447, 34149 Trieste, Italy.
authors.forename: Danae
authors.initials: D
authors.lastname: Pracella
authors.forename: Serena
authors.initials: S
authors.lastname: Bonin
authors.forename: Renzo
authors.initials: R
authors.lastname: Barbazza
authors.forename: Anna
authors.initials: A
authors.lastname: Sapino
authors.forename: Isabella
authors.initials: I
authors.lastname: Castellano
authors.forename: Sandro
authors.initials: S
authors.lastname: Sulfaro
authors.forename: Giorgio
authors.initials: G
authors.lastname: Stanta
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000378:metabolism* / Q000401:mortality* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000378:metabolism* / Q000401:mortality* / Q000556:secondary; D049109:Cell Proliferation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D014746:Vimentin / Q000378:metabolism
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D014746:Vimentin; C508053:ERBB2 protein, human