title: The efficacy of molecular subtyping in predicting postoperative recurrence in breast-conserving therapy: a 15-study meta-analysis.
abstract: BACKGROUND
  Recent research displays that breast cancer (BC) is a heterogeneous disease and distinct molecular subtypes yield different prognostic outcomes.
  
  
  METHODS
  We conducted a meta-analysis to clarify the role of molecular subtypes in recurrence risk after breast-conserving therapy (BCT). Eligible studies of single- (ER, PR, Her-2, and p53) and triple-molecular (Luminal A, Luminal B, Her-2, triple-negative) subtypes were identified through multiple search strategies. Pooled hazard ratios with 95% confidence intervals were calculated to assess this research topic.
  
  
  RESULTS
  Fifteen studies involving 21,645 participants were included in the meta-analysis. Her-2 positive patients had a significantly higher recurrence risk in both overall merge (HR = 1.97, 95% CI: 1.41-2.75) and subtotal merge of local recurrence (LR) (HR = 1.93, 95% CI: 1.34-2.78). Significantly higher risk of recurrence was also observed in p53 positive patients by overall merge (HR = 1.78, 95% CI: 1.49 -2.12) and subtotal merge of LR (HR = 1.73, 95% CI: 1.44-2.07). When setting Luminal A as a baseline, Luminal B, Her-2, and triple-negative all showed significantly increased risk for both LR and distant recurrence (DR). Comparing triple-negative and non-triple-negative subtypes showed the biggest risk for overall recurrence (HR = 3.19, 95% CI: 1.91-5.31) and LR (HR = 3.31, 95% CI: 1.69-6.45).
  
  
  CONCLUSIONS
  Our meta-analysis showed significant differences in recurrence risk among various molecular subtypes after BCT. Although Her-2 and p53 positive subtypes can be considered independent prognostic biomarkers for indicating high LR risk, triple-molecular biomarkers showed higher clinical value. Triple-negative subtype showed the highest recurrence risk among all subtypes, and adjuvant chemotherapy should be considered for it.
authors.forename: Jing
authors.initials: J
authors.lastname: Chen
authors.forename: Peng
authors.initials: P
authors.lastname: Jiang
authors.forename: Han-Jin
authors.initials: HJ
authors.lastname: Wang
authors.forename: Jia-Yi
authors.initials: JY
authors.lastname: Zhang
authors.forename: Yang
authors.initials: Y
authors.lastname: Xu
authors.forename: Mu-Hong
authors.initials: MH
authors.lastname: Guo
authors.forename: Bin
authors.initials: B
authors.lastname: Zhang
authors.forename: Chong-Yin
authors.initials: CY
authors.lastname: Tang
authors.forename: Hong-Yong
authors.initials: HY
authors.lastname: Cao
authors.affiliation: Department of Breast Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, China. ws0801@hotmail.com.
authors.forename: Shui
authors.initials: S
authors.lastname: Wang
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000150:complications / Q000378:metabolism / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000009:adverse effects*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone