| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Hung, Shih-Kai Yang, Hsuan-Ju Lee, Moon-Sing Liu, Dai-Wei Chen, Liang-Cheng Chew, Chia-Hui Lin, Chun-Hung Lee, Cheng-Hung Li, Szu-Chin Hong, Chung-Lin Yu, Chih-Chia Yu, Ben-Hui Hsu, Feng-Chun Chiou, Wen-Yen Lin, Hon-Yi |
| Abstract | Background Based on the molecular expression of cancer cells, molecular subtypes of breast cancer have been applied to classify patients for predicting clinical outcomes and prognosis. However, further evidence is needed regarding the influence of molecular subtypes on the efficacy of radiotherapy (RT) after breast-conserving surgery (BCS), particularly in a population-based context. Hence, the present study employed a propensity-score-matched cohort design to investigate the potential role of molecular subtypes in stratifying patient outcomes for post-BCS RT and to identify the specific clinical benefits that may emerge. Methods From 2006 to 2019, the present study included 59,502 breast cancer patients who underwent BCS from the Taiwan National Health Insurance Research Database. Propensity scores were utilized to match confounding variables between patients with and without RT within each subtype of breast cancer, namely luminal A, luminal B/HER2-negative, luminal B/HER2-positive, basal-like, and HER2-enriched ones. Several clinical outcomes were assessed, in terms of local recurrence (LR), regional recurrence (RR), distant metastasis (DM), disease-free survival (DFS), and overall survival (OS). Results After post-BCS RT, patients with luminal A and luminal B/HER2-positive breast cancers exhibited a decrease in LR (adjusted hazard ratio [aHR] = 0.18, p < 0.0001; and, 0.24, p = 0.0049, respectively). Furthermore, reduced RR and improved DFS were observed in patients with luminal A (aHR = 0.15, p = 0.0004; and 0.29, p < 0.0001), luminal B/HER2-negative (aHR = 0.06, p = 0.0093; and, 0.46, p = 0.028), and luminal B/HER2-positive (aHR = 0.14, p = 0.01; and, 0.38, p < 0.0001) breast cancers. Notably, OS benefits were found in patients with luminal A (aHR = 0.62, p = 0.002), luminal B/HER2-negative (aHR = 0.30, p < 0.0001), basal-like (aHR = 0.40, p < 0.0001), and HER2-enriched (aHR = 0.50, p = 0.03), but not luminal B/HER2-positive diseases. Remarkably, when considering DM, luminal A patients who received RT demonstrated a lower cumulative incidence of DM than those without RT (p = 0.02). Conclusion In patients with luminal A breast cancer who undergo BCS, RT could decrease the likelihood of tumor metastasis. After RT, the tumor’s hormone receptor status may predict tumor control regarding LR, RR, and DFS. Besides, the HER2 status of luminal breast cancer patients may serve as an additional predictor of OS after post-BCS RT. However, further prospective studies are required to validate these findings. |
| Related Links | https://breast-cancer-research.biomedcentral.com/counter/pdf/10.1186/s13058-023-01747-9.pdf |
| Ending Page | 14 |
| Page Count | 14 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| DOI | 10.1186/s13058-023-01747-9 |
| Journal | Breast Cancer Research |
| Issue Number | 1 |
| Volume Number | 25 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2023-12-08 |
| Access Restriction | Open |
| Subject Keyword | Cancer Research Oncology Surgical Oncology Molecular subtypes Breast-conserving surgery (BCS) Radiotherapy (RT) Propensity-score match (PSM) Breast cancer |
| Content Type | Text |
| Resource Type | Article |
| Subject | Cancer Research Oncology |
| Journal Impact Factor | 6.1/2023 |
| 5-Year Journal Impact Factor | 7.1/2023 |
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