Prognostic Value of the Progesterone Receptor by Subtype in Patients with Estrogen Receptor-Positive, HER-2 Negative Breast Cancer.

Breast Neoplasms / genetics Female Humans Prognosis Receptors, Progesterone / metabolism Survival Analysis
Age Breast cancer Luminal Progesterone receptor Prognostic value Subtype

Journal

The oncologist
ISSN: 1549-490X
Titre abrégé: Oncologist
Pays: England
ID NLM: 9607837

Informations de publication

Date de publication:
02 2019
Historique:
received: 22 03 2018
accepted: 28 06 2018
pubmed: 2 9 2018
medline: 21 3 2020
entrez: 2 9 2018
Statut: ppublish

Résumé

In estrogen receptor-positive (ER+), human epidermal growth factor receptor 2 (HER-2) negative breast cancers, the progesterone receptor (PR) is an independent prognostic marker. Little is known about the prognostic value of PR by tumor grade. We assessed this in two independent datasets. Women with primary operable, invasive ER+ HER-2 negative breast cancer diagnosed between 2000 and 2012, treated at University Hospitals Leuven, were included. We assessed the association of PR status and subtype (grade 1-2 vs. grade 3) with distant recurrence-free interval (DRFI) and breast cancer-specific survival. The interaction between PR status and subtype was investigated, and associations of PR status by subtype were calculated. The BIG 1-98 data set was used for validation. In total, 4,228 patients from Leuven and 5,419 from BIG 1-98 were analyzed. In the Leuven cohort, the adjusted hazard ratio (HR) of PR-positive versus PR-negative tumors for DRFI was 0.66 (95% confidence interval [CI], 0.50-0.89). For the interaction with subtype ( PR positivity may be more protective against metastatic relapse in luminal B-like versus luminal A-like breast cancer, but no strong conclusions can be made. In absolute risk, results suggest an absent PR is clinically more important in high compared with low proliferative ER+ HER-2 negative tumors. An absent progesterone receptor (PR) predicts a worse outcome in women treated for an estrogen receptor-positive, human epidermal growth factor receptor 2 negative breast cancer. As low proliferative tumors lacking PR are now also classified high risk, the prognostic value of PR across risk groups was studied. Despite a negative test for interaction of the prognostic value of PR by tumor grade, the magnitude of an absent PR on breast cancer relapse is much larger in high than in low proliferative breast cancers.

Sections du résumé

BACKGROUND
In estrogen receptor-positive (ER+), human epidermal growth factor receptor 2 (HER-2) negative breast cancers, the progesterone receptor (PR) is an independent prognostic marker. Little is known about the prognostic value of PR by tumor grade. We assessed this in two independent datasets.
PATIENTS AND METHODS
Women with primary operable, invasive ER+ HER-2 negative breast cancer diagnosed between 2000 and 2012, treated at University Hospitals Leuven, were included. We assessed the association of PR status and subtype (grade 1-2 vs. grade 3) with distant recurrence-free interval (DRFI) and breast cancer-specific survival. The interaction between PR status and subtype was investigated, and associations of PR status by subtype were calculated. The BIG 1-98 data set was used for validation.
RESULTS
In total, 4,228 patients from Leuven and 5,419 from BIG 1-98 were analyzed. In the Leuven cohort, the adjusted hazard ratio (HR) of PR-positive versus PR-negative tumors for DRFI was 0.66 (95% confidence interval [CI], 0.50-0.89). For the interaction with subtype (
CONCLUSION
PR positivity may be more protective against metastatic relapse in luminal B-like versus luminal A-like breast cancer, but no strong conclusions can be made. In absolute risk, results suggest an absent PR is clinically more important in high compared with low proliferative ER+ HER-2 negative tumors.
IMPLICATIONS FOR PRACTICE
An absent progesterone receptor (PR) predicts a worse outcome in women treated for an estrogen receptor-positive, human epidermal growth factor receptor 2 negative breast cancer. As low proliferative tumors lacking PR are now also classified high risk, the prognostic value of PR across risk groups was studied. Despite a negative test for interaction of the prognostic value of PR by tumor grade, the magnitude of an absent PR on breast cancer relapse is much larger in high than in low proliferative breast cancers.

Identifiants

DOI: 10.1634/theoncologist.2018-0176 PMID: 30171067 PMC: PMC6369957
pubmed: 30171067
pii: theoncologist.2018-0176
doi: 10.1634/theoncologist.2018-0176
pmc: PMC6369957
doi:

Substances chimiques

Receptors, Progesterone 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

165-171

Informations de copyright

© AlphaMed Press 2018.

Déclaration de conflit d'intérêts

Disclosures of potential conflicts of interest may be found at the end of this article.

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Auteurs

Kathleen Van Asten (K)

Department of Oncology, KU Leuven - University of Leuven, Leuven, Belgium.

Laurence Slembrouck (L)

Department of Oncology, KU Leuven - University of Leuven, Leuven, Belgium.
ORCID: 0000-0002-4138-7630

Siel Olbrecht (S)

Department of Oncology, KU Leuven - University of Leuven, Leuven, Belgium.
Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.

Lynn Jongen (L)

Department of Oncology, KU Leuven - University of Leuven, Leuven, Belgium.

Olivier Brouckaert (O)

Department of Gynecology and Obstetrics, Senology, Jan Yperman Hospital, Ypres, Belgium.

Hans Wildiers (H)

Department of Oncology, KU Leuven - University of Leuven, Leuven, Belgium.
Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.
ORCID: 0000-0001-8990-7837

Giuseppe Floris (G)

Laboratory of Translational Cell & Tissue Research, Department of Imaging and Pathology, KU Leuven - University of Leuven, Leuven, Belgium.
Department of Pathology, University Hospitals Leuven, Leuven, Belgium.

Erik Van Limbergen (E)

Department of Oncology, KU Leuven - University of Leuven, Leuven, Belgium.
Department of Radiotherapy Oncology, University Hospitals Leuven, Leuven, Belgium.

Caroline Weltens (C)

Department of Oncology, KU Leuven - University of Leuven, Leuven, Belgium.
Department of Radiotherapy Oncology, University Hospitals Leuven, Leuven, Belgium.

Ann Smeets (A)

Department of Oncology, KU Leuven - University of Leuven, Leuven, Belgium.
Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium.

Robert Paridaens (R)

Department of Oncology, KU Leuven - University of Leuven, Leuven, Belgium.
Department of General Medical Oncology, University Hospitals Leuven, Leuven, Belgium.

Anita Giobbie-Hurder (A)

Department of Biostatistics and Computational Biology, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.

Meredith M Regan (MM)

Department of Biostatistics and Computational Biology, International Breast Cancer Study Group Statistical Center, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.

Giuseppe Viale (G)

Division of Pathology and Laboratory Medicine, European Institute of Oncology, University of Milan, Milan, Italy.

Beat Thürlimann (B)

Breast Center St. Gallen, Cantonal Hospital, St. Gallen, Switzerland.
International Breast Cancer Study Group, Bern, Switzerland.
Swiss Group for Clinical Cancer Research, Bern, Switzerland.

Ignace Vergote (I)

Department of Oncology, KU Leuven - University of Leuven, Leuven, Belgium.
Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.

Evangelia Christodoulou (E)

Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium.

Ben Van Calster (B)

Department of Development and Regeneration, KU Leuven - University of Leuven, Leuven, Belgium.

Patrick Neven (P)

Department of Oncology, KU Leuven - University of Leuven, Leuven, Belgium patrick.neven@uzleuven.be.
Department of Gynecology and Obstetrics, University Hospitals Leuven, Leuven, Belgium.

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Classifications MeSH

questionsmedicales.fr › Maladies de la peau et du tissu conjonctif › Maladies de la peau › Maladies du sein › Tumeurs du sein › Prognostic Value of the Progesterone Receptor...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Prognostic Value of the Progesterone Receptor...
questionsmedicales.fr › Diagnostic › Pronostic › Prognostic Value of the Progesterone Receptor...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Récepteurs cytoplasmiques et nucléaires › Récepteurs à la progestérone › Prognostic Value of the Progesterone Receptor...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Analyse de survie › Prognostic Value of the Progesterone Receptor...