Publication

Differential prognostic relevance of patho-anatomical factors among different tumor-biological subsets of breast cancer: Results from the adjuvant SUCCESS A study

Journal Paper/Review - Dec 20, 2018

Units
PubMed
Doi

Citation
Deniz M, Andergassen U, Steidl J, Trapp E, Fasching P, Häberle L, Beckmann M, Schneeweiss A, Schrader I, Janni W, Rack B, Jueckstock J, Kost B, deGregorio A, DeGregorio N, Bekes I, Widschwendter P, Schochter F, Ernst K, Scholz C, Bauer E, Aivazova-Fuchs V, Weissenbacher T, Friedl T. Differential prognostic relevance of patho-anatomical factors among different tumor-biological subsets of breast cancer: Results from the adjuvant SUCCESS A study. Breast 2018; 44:81-89.
Type
Journal Paper/Review (English)
Journal
Breast 2018; 44
Publication Date
Dec 20, 2018
Issn Electronic
1532-3080
Pages
81-89
Brief description/objective

OBJECTIVES
In breast cancer, large tumor size, positive nodal stage and a triple-negative tumor subtype are associated with reduced survival, but the interactions between these prognostic factors are not well understood.

MATERIAL AND METHODS
Here we re-evaluated the impact of tumor size, nodal stage and tumor subtype on disease-free survival (DFS), overall survival (OS), distant disease-free survival (DDFS) and breast cancer specific survival (BCSS) in a retrospective analysis using data from the adjuvant SUCCESS A trial. Subgroup analyses were conducted to assess whether the effect of tumor size and nodal stage on survival depended on tumor subtype.

RESULTS
Increasing tumor size, higher nodal stage and triple negative breast cancer (TNBC) were associated with unfavorable prognosis (all p < 0.001). There was no significant interaction between tumor subtype and tumor size (p > 0.5 for all four survival endpoints), but we found significant interactions between tumor subtype and nodal stage (p < 0.05 for all four survival endpoints), with no differences in survival among tumor subtypes for patients with pN0 tumors (all p > 0.05) and pronounced differences in survival among tumor subtypes for patients with positive nodal stage (all p < 0.001).

CONCLUSIONS
This analysis confirms tumor size, nodal stage and tumor subtype as independent prognostic factors in high-risk early breast cancer. Nodal-positive patients with TNBC had a considerably worse outcome compared to nodal-positive patients with another tumor subtype. This underlines the importance for early detection particularly for patients with TNBC.

TRIAL REGISTRATION
EudraCT 2005-000490-21; ClinicalTrials.gov Identifier: NCT02181101.