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. 2018 Jul;144(7):1347-1355.
doi: 10.1007/s00432-018-2644-2. Epub 2018 Apr 19.

Patterns of breast cancer relapse in accordance to biological subtype

Atanas Ignatov  1 , Holm Eggemann  2 , Elke Burger  3 , Tanja Ignatov  2
Affiliations

Patterns of breast cancer relapse in accordance to biological subtype

Atanas Ignatov et al. J Cancer Res Clin Oncol. 2018 Jul.

Abstract

Purpose: To evaluate the pattern of recurrence of breast cancer according to its biological subtype in a large cohort of patients treated with therapy representative of current practice.

Patients and methods: Patients treated between 2000 and 2016 with known biological subtype were eligible. Data were prospectively collected. Primary endpoint was the subtype-dependent pattern and time of recurrence. Loco-regional and distant site and time of recurrence were assessed.

Results: Median follow-up time was 80.8 months. For 12,053 (82.5%) of 14,595 patients with primary non-metastatic invasive breast cancer a subtype classification was possible. The luminal A subtype had the highest 10-year survival followed by luminal B and luminal/HER2. The worst survival demonstrated HER2 enriched and TNBC. HER2 and TNBC had the highest rate of recurrence in the first 5 years, whereas the rate of recurrence for luminal A and luminal B tumors was initially low, but remained continuously even after 10 years of follow-up. Luminal A tumors demonstrated the lowest rate of distant metastases predominantly in bone. So did luminal B tumors. HER2 enriched subtype was characterized with increased rate of loco-regional recurrence and distant metastases in bone, liver and brain. Luminal/HER2 had pattern of relapse similar to HER2 enriched tumors, with exception of loco-regional relapse and brain metastases. TNBC had higher rate of lung, bone and brain metastases as well as loco-regional relapse.

Conclusion: Breast cancer subtypes are associated with different time and pattern of recurrence and it should be considered during treatment decision.

Keywords: Breast cancer; Metastasis; Recurrence; Subtype.

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