Prognostic effect of estrogen receptor status across age in primary breast cancer

被引:126
作者
Bentzon, Niels [1 ]
Duering, Maria [2 ]
Rasmussen, Birgitte Bruun [3 ]
Mouridsen, Henning [2 ]
Kroman, Niels [4 ]
机构
[1] Herlev Univ Hosp, Dept Breast Surg, DK-2730 Herlev, Denmark
[2] Rigshosp, Danish Breast Canc Cooperat Grp, DK-2100 Copenhagen, Denmark
[3] Roskilde Cty Hosp, Dept Pathol, Roskilde, Denmark
[4] Rigshosp, Dept Breast & Endocrine Surg, Copenhagen, Denmark
关键词
breast cancer; estrogen receptor; prognosis; age;
D O I
10.1002/ijc.22892
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Estrogen receptor (ER) status is considered as an important prognostic factor as well as a predictive factor for endocrine responsiveness in breast cancer. We analyzed the distribution of ER status across age and estimated variations in the prognostic impact of ER status related to patients' age and time since diagnosis. Overall, 26,944 patients with primary breast cancer diagnosed from 1989 to 2004 were included. The proportion of ER positive tumors increased over age from 51 to 82%. In multivariate analysis of overall survival, ER positive status was found to be a significantly positive prognostic factor over all age groups. This effect was limited to the first 5 years after diagnosis, RR: 2.08 (95% CI: 1.95-2.22, p < 0.0001). Overall survival during the following 5 years was slightly superior for women with ER negative tumors, RR of death: 0.89 (95% CI: 0.79-1.00, p = 0.049). Results were unchanged in patients who did not receive adjuvant systemic therapy (n = 6,272). Thus; positive ER status does not confer a negative impact on survival in young women as has been previously reported. The inferior prognosis for ER negative patients during the first 5 years after diagnosis changes into a slightly superior residual prognosis compared to ER positive patients independent of use of adjuvant systemic therapy. This may have an impact on future designing of guidelines for adjuvant endocrine therapy beyond 5 years. (c) 2007 Wiley-Liss, Inc.
引用
收藏
页码:1089 / 1094
页数:6
相关论文
共 16 条
[1]  
Abe O, 2005, LANCET, V365, P1687, DOI 10.1016/s0140-6736(05)66544-0
[2]   Is chemotherapy alone adequate for young women with oestrogen-receptor-positive breast cancer? [J].
Aebi, S ;
Gelber, S ;
Castiglione-Gertsch, M ;
Gelber, RD ;
Collins, J ;
Thürlimann, B ;
Rudenstam, CM ;
Lindtner, J ;
Crivellari, D ;
Cortes-Funes, H ;
Simoncini, E ;
Werner, ID ;
Coates, AS ;
Goldhirsch, A .
LANCET, 2000, 355 (9218) :1869-1874
[3]   DANISH-BREAST-CANCER-COOPERATIVE-GROUP (DBCG) - A DESCRIPTION OF THE REGISTER OF THE NATION-WIDE PROGRAM FOR PRIMARY BREAST-CANCER [J].
ANDERSEN, KW ;
MOURIDSEN, HT .
ACTA ONCOLOGICA, 1988, 27 (6A) :627-647
[4]   ESTROGEN AND PROGESTERONE-RECEPTOR ANALYSES IN MORE THAN 4000 HUMAN BREAST-CANCER SAMPLES - A STUDY WITH SPECIAL REFERENCE TO AGE AT DIAGNOSIS AND STABILITY OF ANALYSES [J].
FERNO, M ;
BORG, A ;
JOHANSSON, U ;
NORGREN, A ;
OLSSON, H ;
RYDEN, S ;
SELLBERG, G .
ACTA ONCOLOGICA, 1990, 29 (02) :129-135
[5]   Meeting highlights:: International Expert Consensus on the Primary Therapy of Early Breast Cancer 2005 [J].
Goldhirsch, A ;
Glick, JH ;
Gelber, RD ;
Coates, AS ;
Thürlimann, B ;
Senn, H ;
Albain, KS ;
Bergh, J ;
Castiglione-Gertsch, M ;
Coates, AS ;
Costa, A ;
Cuzick, J ;
Davidson, N ;
Forbes, JF ;
Gelber, RD ;
Goss, P ;
Harris, J ;
Glick, JH ;
Goldhirsch, A ;
Howell, A ;
Ingle, JN ;
Jakesz, R ;
Jassem, J ;
Kaufmann, M ;
Martin, M ;
Mauriac, L ;
Morrow, M ;
Mouridsen, HT ;
Namer, M ;
Piccart-Gebhart, MJ ;
Possinger, K ;
Pritchard, K ;
Rutgers, EJT ;
Thürlimann, B ;
Viale, G ;
Wallgren, A ;
Wood, WC .
ANNALS OF ONCOLOGY, 2005, 16 (10) :1569-1583
[6]   Time-dependence of hazard ratios for prognostic factors in primary breast cancer [J].
Hilsenbeck, SG ;
Ravdin, PM ;
de Moor, CA ;
Chamness, GC ;
Osborne, CK ;
Clark, GM .
BREAST CANCER RESEARCH AND TREATMENT, 1998, 52 (1-3) :227-237
[7]   Factors influencing the effect of age on prognosis in breast cancer: population based study [J].
Kroman, N ;
Jensen, MB ;
Wohlfahrt, J ;
Mouridsen, HT ;
Andersen, PK ;
Melbye, M .
BRITISH MEDICAL JOURNAL, 2000, 320 (7233) :474-478
[8]   Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen:: Danish Breast Cancer Cooperative Group DBCG 82c randomised trial [J].
Overgaard, M ;
Jensen, MB ;
Overgaard, J ;
Hansen, PS ;
Rose, C ;
Andersson, M ;
Kamby, C ;
Kjær, M ;
Gadeberg, CC ;
Rasmussen, BB ;
Blichert-Toft, M ;
Mouridsen, HT .
LANCET, 1999, 353 (9165) :1641-1648
[9]   Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy [J].
Overgaard, M ;
Hansen, PS ;
Overgaard, J ;
Rose, C ;
Andersson, M ;
Bach, F ;
Kjaer, M ;
Gadeberg, CC ;
Mouridsen, HT ;
Jensen, MB ;
Zedeler, K .
NEW ENGLAND JOURNAL OF MEDICINE, 1997, 337 (14) :949-955
[10]   Frequency of oestrogen and progesterone receptor positivity by immunohistochemical analysis in 7016 breast carcinomas: correlation with patient age, assay sensitivity, threshold value, and mammographic screening [J].
Rhodes, A ;
Jasani, B ;
Balaton, AJ ;
Barnes, DM ;
Miller, KD .
JOURNAL OF CLINICAL PATHOLOGY, 2000, 53 (09) :688-696