P4-09-03: Clinical Significance of HER2+ and Triple-Negative Status in Patients with Tumor Size ≤ 1 cm and Node Negative Breast Cancer.

Author(s):  
T Shao ◽  
SK Boolbol ◽  
K Boachie-Adjei ◽  
P Klein
2010 ◽  
Vol 28 (18) ◽  
pp. 2966-2973 ◽  
Author(s):  
Marco Colleoni ◽  
Bernard F. Cole ◽  
Giuseppe Viale ◽  
Meredith M. Regan ◽  
Karen N. Price ◽  
...  

Purpose Retrospective studies suggest that primary breast cancers lacking estrogen receptor (ER) and progesterone receptor (PR) and not overexpressing human epidermal growth factor receptor 2 (HER2; triple-negative tumors) are particularly sensitive to DNA-damaging chemotherapy with alkylating agents. Patients and Methods Patients enrolled in International Breast Cancer Study Group Trials VIII and IX with node-negative, operable breast cancer and centrally assessed ER, PR, and HER2 were included (n = 2,257). The trials compared three or six courses of adjuvant classical cyclophosphamide, methotrexate, and fluorouracil (CMF) with or without endocrine therapy versus endocrine therapy alone. We explored patterns of recurrence by treatment according to three immunohistochemically defined tumor subtypes: triple negative, HER2 positive and endocrine receptor absent, and endocrine receptor present. Results Patients with triple-negative tumors (303 patients; 13%) were significantly more likely to have tumors > 2 cm and grade 3 compared with those in the HER2-positive, endocrine receptor–absent, and endocrine receptor–present subtypes. No clear chemotherapy benefit was observed in endocrine receptor–present disease (hazard ratio [HR], 0.90; 95% CI, 0.74 to 1.11). A statistically significantly greater benefit for chemotherapy versus no chemotherapy was observed in triple-negative breast cancer (HR, 0.46; 95% CI, 0.29 to 0.73; interaction P = .009 v endocrine receptor–present disease). The magnitude of the chemotherapy effect was lower in HER2-positive endocrine receptor–absent disease (HR, 0.58; 95% CI, 0.29 to 1.17; interaction P = .24 v endocrine receptor–present disease). Conclusion The magnitude of benefit of CMF chemotherapy is largest in patients with triple-negative, node-negative breast cancer.


1986 ◽  
Vol 7 (3) ◽  
pp. 161-169 ◽  
Author(s):  
Rosella Silvestrini ◽  
Maria Grazia Daidone ◽  
Giovanni Di Fronzo ◽  
Alberto Morabito ◽  
Pinuccia Valagussa ◽  
...  

Cancer ◽  
2010 ◽  
Vol 116 (8) ◽  
pp. 1987-1991 ◽  
Author(s):  
Elisa Rush Port ◽  
Sujata Patil ◽  
Michelle Stempel ◽  
Monica Morrow ◽  
Hiram S. Cody

2021 ◽  
Author(s):  
Genevieve A Fasano ◽  
Solange Bayard ◽  
Yalei Chen ◽  
Leticia Varella ◽  
Tessa Cigler ◽  
...  

Abstract Purpose: National Comprehensive Cancer Network guidelines recommend delivery of adjuvant chemotherapy in node-negative triple negative breast cancer (TNBC) if the tumor is > 1 cm and consideration of adjuvant chemotherapy for T1b but not T1a disease. These recommendations are based upon sparse data regarding the role of adjuvant chemotherapy in T1a and T1b node-negative TNBC. Our objective was to clarify the benefits of chemotherapy for patients with T1N0 TNBC, stratified by tumor size.Methods: We performed a retrospective analysis of survival outcomes in an IRB-approved prospectively-maintained database of TNBC patients treated at two academic institutions in the United States from 1999-2018. Primary tumor size, histology, and nodal status were based upon definitive surgical pathology. Mean follow-up was 5.3 years.Results: 756 TNBC cases were analyzed; 258 T1N0 TNBC patients were identified. Adjuvant chemotherapy was delivered to 30.5% of T1a, 64.7% T1b, and 83.9% T1c (p < 0.0001). Factors associated with delivery of adjuvant chemotherapy were age, histology, high-grade disease, and postoperative adjuvant radiation therapy. At a mean follow-up of 5.3 years, increase in overall survival was associated with use of chemotherapy in patients with T1c disease (93.2% v. 75.2% p = 0.008) but not in those with T1a (100% v. 100% p = 0.3778) or T1b (100% v. 95.8% p = 0.2362) disease.Conclusion: Our data support current guidelines indicating benefit from adjuvant chemotherapy in node-negative TNBC associated with T1c tumors but excellent outcomes were observed in cases of T1a and T1b disease, regardless of whether adjuvant chemotherapy was delivered.


2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12021-e12021
Author(s):  
Samip R. Master ◽  
Neelakanta Dadi ◽  
Chintan Shah ◽  
Gary Von Burton ◽  
Runhua Shi

e12021 Background: There is currently lack of adequate data to support for or against the role of adjuvant chemotherapy for small( < = 5mm) hormone negative and node negative breast cancer. We did a retrospective analysis from National Cancer Database (NCDB) to assess the effect of adjuvant chemotherapy in HER2 positive/ Hormone receptor negative (HER+HR-) and triple negative breast cancer. Methods: Data was analyzed from approximately nine thousand women registered in the (NCDB) who were diagnosed with triple negative and HER+ HR-small ( < = 5mm) and node negative breast cancer between 2010 and 2014 and had follow-up to the end of 2015. The primary predictor variable was the receipt of chemotherapy, and outcome variable was overall survival. Additional variables addressed and adjusted included age, race, Charlson Comorbidity Index and grade of cancer. Results: Approximately 59% patients received adjuvant chemotherapy. The five year overall survival in women with triple negative for breast cancer who received chemotherapy was 79% , compared to 87% , for those who did not receive chemotherapy(p < 0.00001). The five year overall survival in women with Her2+HR- for breast cancer who received chemotherapy was 68% , compared to 84% , for those who did not receive chemotherapy(p < 0.00001).In multivariate analysis, after adjusting for secondary predictor variables, avoidance of adjuvant chemotherapy was associated with 59.5% reduction in risk of death. Conclusions: Our analysis suggests that there are no role for adjuvant chemo in small breast cancers that are Her+ HR- and triple negative. The receipt of adjuvant chemotherapy lead to decrease in overall survival.


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