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Would 1.0 cm be a more suitable cutoff to subdivide pT1 tumors in hormone receptor-negative and HER2-positive breast cancer?
Cancer Medicine 2018 November
BACKGROUND: HER2+ and hormone receptor (HoR)-negative breast cancer usually associated with poor outcome. However, it remained elusive for the prognosis of small (T1a-T1c) HER2+/HoR- breast cancer. The present study retrospectively analyzed the Surveillance, Epidemiology, and End Results (SEER) database to explore the clinicopathological characteristics and prognosis of T1a-T1c HER2+/HoR- breast cancer.
MATERIAL AND METHODS: Data for patients diagnosed with either HER2-/HoR+or HER2+/HoR- T1a-T1c breast cancer between 2010 and 2012 were obtained from SEER program. Survival analyses were conducted by Kaplan-Meier method and Cox proportion hazard regression.
RESULTS: Totally, 2648 HER2+/HoR- and 56387 HER2-/HoR+T1a-T1c breast cancer patients were enrolled. There was a clear trend that tumor size had a positive correlation with advanced AJCC stage (P < 0.001) and N-stage (P < 0.001). T1a and T1b HER2+/HoR- breast cancer had great homogeneity in that these two subgroups had comparable survival and both showed no significant survival difference with its counterpart of HER2-/HoR+subtype. Conversely, T1c HER2+/HoR- breast cancers revealed worse prognosis than T1a/T1b HER2+/HoR- and T1c HER2-/HoR+tumors (BCSS HR 3.847, P < 0.001; OS HR 2.055, P < 0.001).
CONCLUSION: T1a and T1b HER2+/HoR- breast cancer had favorable prognosis and great homogeneity, indicating 1.0 cm may be a suitable cutoff for subclassification of T1 cancer. Future randomized clinical trials were warranted to verify this hypothesis and elucidate the biological behavior of small T1 tumor to facilitate precise medicine.
MATERIAL AND METHODS: Data for patients diagnosed with either HER2-/HoR+or HER2+/HoR- T1a-T1c breast cancer between 2010 and 2012 were obtained from SEER program. Survival analyses were conducted by Kaplan-Meier method and Cox proportion hazard regression.
RESULTS: Totally, 2648 HER2+/HoR- and 56387 HER2-/HoR+T1a-T1c breast cancer patients were enrolled. There was a clear trend that tumor size had a positive correlation with advanced AJCC stage (P < 0.001) and N-stage (P < 0.001). T1a and T1b HER2+/HoR- breast cancer had great homogeneity in that these two subgroups had comparable survival and both showed no significant survival difference with its counterpart of HER2-/HoR+subtype. Conversely, T1c HER2+/HoR- breast cancers revealed worse prognosis than T1a/T1b HER2+/HoR- and T1c HER2-/HoR+tumors (BCSS HR 3.847, P < 0.001; OS HR 2.055, P < 0.001).
CONCLUSION: T1a and T1b HER2+/HoR- breast cancer had favorable prognosis and great homogeneity, indicating 1.0 cm may be a suitable cutoff for subclassification of T1 cancer. Future randomized clinical trials were warranted to verify this hypothesis and elucidate the biological behavior of small T1 tumor to facilitate precise medicine.
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