Locoregional Control According to Breast Cancer Subtype and Response to Neoadjuvant Chemotherapy in Breast Cancer Patients Undergoing Breast-conserving Therapy

Shannon K. Swisher, Jose Vila, Susan L. Tucker, Isabelle Bedrosian, Simona F. Shaitelman, Jennifer K. Litton, Benjamin D. Smith, Abigail S. Caudle, Henry M. Kuerer, Elizabeth A. Mittendorf

Research output: Contribution to journalArticle

Abstract

Background: Our group previously published data showing that patients could be stratified by constructed molecular subtype with respect to locoregional recurrence (LRR)-free survival after neoadjuvant chemotherapy and breast-conserving therapy (BCT). That study predated use of trastuzumab for human epidermal growth factor receptor 2 (HER2)-positive patients. The current study was undertaken to determine the impact of subtype and response to therapy in a contemporary cohort. Methods: Clinicopathologic data from 751 breast cancer patients who received neoadjuvant chemotherapy (with trastuzumab if HER2+) and BCT from 2005 to 2012 were identified. Hormone receptor (HR) and HER2 status were used to construct molecular subtypes: HR+/HER2 (n = 369), HR+/HER2+ (n = 105), HR/HER2+ (n = 58), and HR/HER2 (n = 219). Actuarial rates of LRR were determined by the Kaplan–Meier method and compared by the log-rank test. Multivariate analysis was performed to determine factors associated with LRR. Results: The pathologic complete response (pCR) rates by subtype were as follows: 16.5 % (HR+/HER2), 45.7 % (HR+/HER2+), 72.4 % (HR/HER2+), and 42.0 % (HR/HER2) (P < 0.001). Median follow-up was 4.6 years. The 5-year LRR-free survival rate for all patients was 95.4 %. Five-year LRR-free survival rates by subtype were 97.2 % (HR+/HER2), 96.1 % (HR+/HER2+), 94.4 % (HR/HER2+), and 93.4 % (HR/HER2) (P = 0.44). For patients with HR/HER2+ disease, the LRR-free survival rates were 97.4 and 86.7 % for those who did and those who did not experience pCR, respectively. For patients with HR/HER2 disease, the LRR-free survival rates were 98.6 % (pCR) versus 89.9 % (no pCR). On multivariate analysis, the HR/HER2 subtype, clinical stage III disease, and failure to experience a pCR were associated with LRR. Conclusions: Patients undergoing BCT after neoadjuvant chemotherapy have excellent rates of 5-year LRR-free survival that are affected by molecular subtype and by response to neoadjuvant chemotherapy.

Original languageEnglish
Pages (from-to)749-756
Number of pages8
JournalAnnals of Surgical Oncology
Volume23
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

Fingerprint

Breast
Breast Neoplasms
Drug Therapy
Hormones
Recurrence
Therapeutics
Survival Rate
human ERBB2 protein
Multivariate Analysis
Neoadjuvant Therapy
Survival

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Locoregional Control According to Breast Cancer Subtype and Response to Neoadjuvant Chemotherapy in Breast Cancer Patients Undergoing Breast-conserving Therapy. / Swisher, Shannon K.; Vila, Jose; Tucker, Susan L.; Bedrosian, Isabelle; Shaitelman, Simona F.; Litton, Jennifer K.; Smith, Benjamin D.; Caudle, Abigail S.; Kuerer, Henry M.; Mittendorf, Elizabeth A.

In: Annals of Surgical Oncology, Vol. 23, No. 3, 01.03.2016, p. 749-756.

Research output: Contribution to journalArticle

Swisher, SK, Vila, J, Tucker, SL, Bedrosian, I, Shaitelman, SF, Litton, JK, Smith, BD, Caudle, AS, Kuerer, HM & Mittendorf, EA 2016, 'Locoregional Control According to Breast Cancer Subtype and Response to Neoadjuvant Chemotherapy in Breast Cancer Patients Undergoing Breast-conserving Therapy', Annals of Surgical Oncology, vol. 23, no. 3, pp. 749-756. https://doi.org/10.1245/s10434-015-4921-5
Swisher, Shannon K. ; Vila, Jose ; Tucker, Susan L. ; Bedrosian, Isabelle ; Shaitelman, Simona F. ; Litton, Jennifer K. ; Smith, Benjamin D. ; Caudle, Abigail S. ; Kuerer, Henry M. ; Mittendorf, Elizabeth A. / Locoregional Control According to Breast Cancer Subtype and Response to Neoadjuvant Chemotherapy in Breast Cancer Patients Undergoing Breast-conserving Therapy. In: Annals of Surgical Oncology. 2016 ; Vol. 23, No. 3. pp. 749-756.
@article{1d3bba09764746de8ff069891d4d2ee1,
title = "Locoregional Control According to Breast Cancer Subtype and Response to Neoadjuvant Chemotherapy in Breast Cancer Patients Undergoing Breast-conserving Therapy",
abstract = "Background: Our group previously published data showing that patients could be stratified by constructed molecular subtype with respect to locoregional recurrence (LRR)-free survival after neoadjuvant chemotherapy and breast-conserving therapy (BCT). That study predated use of trastuzumab for human epidermal growth factor receptor 2 (HER2)-positive patients. The current study was undertaken to determine the impact of subtype and response to therapy in a contemporary cohort. Methods: Clinicopathologic data from 751 breast cancer patients who received neoadjuvant chemotherapy (with trastuzumab if HER2+) and BCT from 2005 to 2012 were identified. Hormone receptor (HR) and HER2 status were used to construct molecular subtypes: HR+/HER2− (n = 369), HR+/HER2+ (n = 105), HR−/HER2+ (n = 58), and HR−/HER2− (n = 219). Actuarial rates of LRR were determined by the Kaplan–Meier method and compared by the log-rank test. Multivariate analysis was performed to determine factors associated with LRR. Results: The pathologic complete response (pCR) rates by subtype were as follows: 16.5 {\%} (HR+/HER2−), 45.7 {\%} (HR+/HER2+), 72.4 {\%} (HR−/HER2+), and 42.0 {\%} (HR−/HER2−) (P < 0.001). Median follow-up was 4.6 years. The 5-year LRR-free survival rate for all patients was 95.4 {\%}. Five-year LRR-free survival rates by subtype were 97.2 {\%} (HR+/HER2−), 96.1 {\%} (HR+/HER2+), 94.4 {\%} (HR−/HER2+), and 93.4 {\%} (HR−/HER2−) (P = 0.44). For patients with HR−/HER2+ disease, the LRR-free survival rates were 97.4 and 86.7 {\%} for those who did and those who did not experience pCR, respectively. For patients with HR−/HER2− disease, the LRR-free survival rates were 98.6 {\%} (pCR) versus 89.9 {\%} (no pCR). On multivariate analysis, the HR−/HER2− subtype, clinical stage III disease, and failure to experience a pCR were associated with LRR. Conclusions: Patients undergoing BCT after neoadjuvant chemotherapy have excellent rates of 5-year LRR-free survival that are affected by molecular subtype and by response to neoadjuvant chemotherapy.",
author = "Swisher, {Shannon K.} and Jose Vila and Tucker, {Susan L.} and Isabelle Bedrosian and Shaitelman, {Simona F.} and Litton, {Jennifer K.} and Smith, {Benjamin D.} and Caudle, {Abigail S.} and Kuerer, {Henry M.} and Mittendorf, {Elizabeth A.}",
year = "2016",
month = "3",
day = "1",
doi = "10.1245/s10434-015-4921-5",
language = "English",
volume = "23",
pages = "749--756",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York LLC",
number = "3",

}

TY - JOUR

T1 - Locoregional Control According to Breast Cancer Subtype and Response to Neoadjuvant Chemotherapy in Breast Cancer Patients Undergoing Breast-conserving Therapy

AU - Swisher, Shannon K.

AU - Vila, Jose

AU - Tucker, Susan L.

AU - Bedrosian, Isabelle

AU - Shaitelman, Simona F.

AU - Litton, Jennifer K.

AU - Smith, Benjamin D.

AU - Caudle, Abigail S.

AU - Kuerer, Henry M.

AU - Mittendorf, Elizabeth A.

PY - 2016/3/1

Y1 - 2016/3/1

N2 - Background: Our group previously published data showing that patients could be stratified by constructed molecular subtype with respect to locoregional recurrence (LRR)-free survival after neoadjuvant chemotherapy and breast-conserving therapy (BCT). That study predated use of trastuzumab for human epidermal growth factor receptor 2 (HER2)-positive patients. The current study was undertaken to determine the impact of subtype and response to therapy in a contemporary cohort. Methods: Clinicopathologic data from 751 breast cancer patients who received neoadjuvant chemotherapy (with trastuzumab if HER2+) and BCT from 2005 to 2012 were identified. Hormone receptor (HR) and HER2 status were used to construct molecular subtypes: HR+/HER2− (n = 369), HR+/HER2+ (n = 105), HR−/HER2+ (n = 58), and HR−/HER2− (n = 219). Actuarial rates of LRR were determined by the Kaplan–Meier method and compared by the log-rank test. Multivariate analysis was performed to determine factors associated with LRR. Results: The pathologic complete response (pCR) rates by subtype were as follows: 16.5 % (HR+/HER2−), 45.7 % (HR+/HER2+), 72.4 % (HR−/HER2+), and 42.0 % (HR−/HER2−) (P < 0.001). Median follow-up was 4.6 years. The 5-year LRR-free survival rate for all patients was 95.4 %. Five-year LRR-free survival rates by subtype were 97.2 % (HR+/HER2−), 96.1 % (HR+/HER2+), 94.4 % (HR−/HER2+), and 93.4 % (HR−/HER2−) (P = 0.44). For patients with HR−/HER2+ disease, the LRR-free survival rates were 97.4 and 86.7 % for those who did and those who did not experience pCR, respectively. For patients with HR−/HER2− disease, the LRR-free survival rates were 98.6 % (pCR) versus 89.9 % (no pCR). On multivariate analysis, the HR−/HER2− subtype, clinical stage III disease, and failure to experience a pCR were associated with LRR. Conclusions: Patients undergoing BCT after neoadjuvant chemotherapy have excellent rates of 5-year LRR-free survival that are affected by molecular subtype and by response to neoadjuvant chemotherapy.

AB - Background: Our group previously published data showing that patients could be stratified by constructed molecular subtype with respect to locoregional recurrence (LRR)-free survival after neoadjuvant chemotherapy and breast-conserving therapy (BCT). That study predated use of trastuzumab for human epidermal growth factor receptor 2 (HER2)-positive patients. The current study was undertaken to determine the impact of subtype and response to therapy in a contemporary cohort. Methods: Clinicopathologic data from 751 breast cancer patients who received neoadjuvant chemotherapy (with trastuzumab if HER2+) and BCT from 2005 to 2012 were identified. Hormone receptor (HR) and HER2 status were used to construct molecular subtypes: HR+/HER2− (n = 369), HR+/HER2+ (n = 105), HR−/HER2+ (n = 58), and HR−/HER2− (n = 219). Actuarial rates of LRR were determined by the Kaplan–Meier method and compared by the log-rank test. Multivariate analysis was performed to determine factors associated with LRR. Results: The pathologic complete response (pCR) rates by subtype were as follows: 16.5 % (HR+/HER2−), 45.7 % (HR+/HER2+), 72.4 % (HR−/HER2+), and 42.0 % (HR−/HER2−) (P < 0.001). Median follow-up was 4.6 years. The 5-year LRR-free survival rate for all patients was 95.4 %. Five-year LRR-free survival rates by subtype were 97.2 % (HR+/HER2−), 96.1 % (HR+/HER2+), 94.4 % (HR−/HER2+), and 93.4 % (HR−/HER2−) (P = 0.44). For patients with HR−/HER2+ disease, the LRR-free survival rates were 97.4 and 86.7 % for those who did and those who did not experience pCR, respectively. For patients with HR−/HER2− disease, the LRR-free survival rates were 98.6 % (pCR) versus 89.9 % (no pCR). On multivariate analysis, the HR−/HER2− subtype, clinical stage III disease, and failure to experience a pCR were associated with LRR. Conclusions: Patients undergoing BCT after neoadjuvant chemotherapy have excellent rates of 5-year LRR-free survival that are affected by molecular subtype and by response to neoadjuvant chemotherapy.

UR - http://www.scopus.com/inward/record.url?scp=84957838409&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84957838409&partnerID=8YFLogxK

U2 - 10.1245/s10434-015-4921-5

DO - 10.1245/s10434-015-4921-5

M3 - Article

AN - SCOPUS:84957838409

VL - 23

SP - 749

EP - 756

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 3

ER -