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Concordance Between ER, PR, HER2 neu Receptors Before and After Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer Cover

Concordance Between ER, PR, HER2 neu Receptors Before and After Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer

Forum of Clinical Oncology
Volume 12 (2021): Issue 1 (May 2021)
By: ,  ,  ,  ,   and    
Open Access
|May 2021
Figures & tables

Figures & Tables

Table 1

Patients and tumor characteristics.

CharacteristicsAll patients (N=110)
No.%
Age (years)
Mean±SD50.84±10.83
Median (Range)51(27 – 73)
<35 years109.1%
≥35 years10090.9%
Side
Right breast4742.7%
Left breast6375.3%
Menopause
Premenopausal5045.5%
Postmenopausal6054.5%
Initial Grade
Grade II3733.6%
Grade III7366.4%
Pathological type
IDC9384.5%
ILC1110%
Other65.5%
Initial T
T187.3%
T23229.1%
T34641.8%
T42421.8%
Initial N
N13027.3%
N25045.5%
N33027.3%
Initial Stage
Stage IIIA6054.5%
Stage IIIB2220%
Stage IIIC2825.5%
Initial LVI
Negative4641.8%
Positive5751.8%
Unknown76.4%
Initial ER status
Negative4540.9%
Positive6559.1%
Initial PR status
Negative5247.3%
Positive5852.7%
Initial HER2 status
+16458.2%
+22320.9%
+32320.9%
Initial HER2 FISH
Negative1715.4%
Positive65.5%
Pre-NCT Tumor Phenotype
HER2−ve & HR+ve6760.9%
HER2+ve & HR+ve65.5%
HER2+ve & HR−ve1311.8%
HER2−ve & HR−ve2421.8%
Neoadjuvant chemotherapy
CMF87.3%
FAC4440%
FEC2220%
AC-T2724.5%
AC-D98.2%
Surgery
BCS1513.6%
MRM9586.4%
ER status at surgery
Negative5247.3%
Positive5852.7%
PR status at surgery
Negative5247.3%
Positive5852.7%
HER2 status at surgery
Negative87.3%
+15751.8%
+22018.2%
+32522.7%
HER2 FISH at surgery
Negative1614.6%
Positive43.6%
HR conversion
Negative to negative3935.5%
Positive to positive4440%
Negative to positive1513.6%
Positive to negative1210.9%
HER2 conversion
Negative to negative7265.5%
Positive to positive2119.1%
Positive to negative87.3%
Negative to positive98.2%
Tumor Phenotype Conversion
Concordant nTN5348.2%
Concordant TN1210.9%
Discordant nTN2825.5%
Discordant TN1715.5%
Adjuvant Herceptin
No76.4%
Yes3128.1%
Adjuvant Hormonal
No3935.5%
Yes7164.5%
Radiotherapy
No2926.4%
Yes8173.6%
Recurrence
No recurrence3935.5%
Recurrence7164.5%
Mortality
Alive10090.9%
Died109.1%
Follow-up duration (months)
Mean±SD24.11±8.75
Median (Range)27(7 – 36)

[i] Continuous variables were expressed as mean ± SD & median (range); categorical variables were expressed as number (percentage).

[ii] FAC (5-fluorouracil, Doxorubicin and Cyclophosphamide), CEF (Cyclophosphamide, Epirubicin and 5-fluorouracil), AC (Doxorubicin and Cyclophosphamide) followed by T (Paclitaxel; CMF (Cyclophosphamide, Methotrexate and 5-fluorouracil), AC-D (Doxorubicin, Cyclophosphamide followed by Docetaxel) HER2: human epidermal growth factor receptor 2; HR: hormone receptor; NCT: neoadjuvant chemotherapy; nTN: non-triple-negative; TN: triple-negative.

Table 2

Comparison of disease Free Survival (DFS) in the different conversion groups.

GroupTotal NN of eventsCensored N (%)Disease Free Survival (DFS)p-value†
Median1-year2-year3-year
HR conversion
Negative to negative392316 (41%)25 months71.8%45%39.4%<0.001
Positive to negative15150 (0%)7 months0%--------
Negative to positive12210 (83.3%)NR91.7%83.3%83.3%
Positive to positive443113 (29.5%)22 months79.5%44.6%26%
HER2 conversion
Negative to negative724428 (38.9%)25 months73.6%69.4%36.9%<0.001
Positive to negative853 (37.5%)12 months50%37.5%37.5%
Negative to positive990 (0%)9 months0%--------
Positive to positive21138 (38.1%)25 months81%51.6%----
Tumor Phenotype Conversion
Concordant nTN532924 (45.3%)27 months84.9%65.2%----<0.001
Concordant TN1275 (41.7%)20 months66.7%50%41.7%
Discordant nTN28253 (10.7%)9 months21.4%14.3%----
Discordant TN17107 (41.2%)22 months58.8%47.1%41.2%

Categorical variables were expressed as percentage; continuous variables were expressed as median; NR: not reached yet;

† Log rank test; p<0.05 is significant; HER2: human epidermal growth factor receptor 2; HR: hormone receptor.

Table 3

Comparison of Overall Survival (OS) in the different conversion groups.

GroupTotal NN of eventsCensored N (%)Overall Survival (OS)p-value†
Median1-year2-year3-year
HR conversion
Negative to negative39534 (87.2%)NR97.4%89.4%85.7%<0.001
Positive to negative15411 (73.3%)----69.1%--------
Negative to positive12111 (91.7%)NR91.7%91.7%91.7%
Positive to positive44044 (100%)NR100%100%100%
HER2 conversion
Negative to negative72567 (93.1%)NR94.3%92.7%92.7%0.365
Positive to negative808 (100%)NR100%100%100%
Negative to positive918 (88.9%)----88.9%88.9%----
Positive to positive21417 (81%)NR90.5%85.4%79.3%
Tumor Phenotype Conversion
Concordant nTN53350 (94.3%)NR98.1%96.2%93.9%0.219
Concordant TN12210 (83.3%)NR90.9%81.8%81.8%
Discordant nTN28424 (85.7%)----84.8%84.8%----
Discordant TN17116 (94.1%)NR94.1%94.1%94.1%

Categorical variables were expressed as percentage; continuous variables were expressed as median; NR: not reached yet;

† Log rank test; p<0.05 is significant; HER2: human epidermal growth factor receptor 2; HR: hormone receptor.

Figure (A)

Kaplan Meier curve shows comparison of Disease Free Survival (DFS) in HR conversion group.

Figure (B)

Kaplan Meier curve shows comparison of Disease Free Survival (DFS) in HER2 conversion group.

Table 4

Univariate Cox regression analysis for Disease Free Survival and Overall Survival.

GroupTotal N (%)DFSOS
HazR (95% CI)p-valueHazR (95% CI)p-value
HR conversion<0.0010.127
Negative to negative39 (35.5%)0.818 (0.477 – 1.405)0.467114437.4470.933
Positive to negative15 (13.6%)12.606 (5.762 – 27.581)<0.001578737.9630.924
Negative to positive12 (10.9%)0.159 (0.038 – 0.667)0.01267638.4020.936
Positive to positive44 (40%)1.0001.000
HER2 conversion<0.0010.557
Negative to negative72 (65.5%)1.023 (0.551 – 1.901)0.9430.381 (0.102 – 1.420)0.151
Positive to negative8 (7.3%)1.295 (0.461 – 3.638)0.6240.0000.987
Negative to positive9 (8.2%)6.104 (2.461 – 15.136)<0.0010.650 (0.072 – 5.864)0.701
Positive to positive21 (19.1%)1.0001.000
Tumor Phenotype Conversion<0.0010.276
Concordant nTN53 (48.2%)1.0001.000
Concordant TN12 (10.9%)1.298 (0.568 – 2.966)0.5363.557 (0.593 – 21.328)0.165
Discordant nTN28 (25.5%)4.548 (2.617 – 7.904)<0.0013.771 (0.823 – 17.280)0.087
Discordant TN17 (15.5%)1.376 (0.670 – 2.826)0.3851.100 (0.114 – 10.577)0.935

[i] HazR: Hazards Ratio; 95% CI: 95% Confidence Interval; DFS: disease-free survival; HER2: human epidermal growth factor receptor 2; HR: hormone receptor; nTN: non-triple-negative; OS: overall survival; TN: triple-negative

Figure (C)

Kaplan Meier curve shows comparison of Disease Free Survival (DFS) in Tumor Phenotype Conversion group.

Figure (2A)

Kaplan Meier curve shows comparison of Overall Survival (OS) in HR conversion group.

Figure (2B)

Kaplan Meier curve shows comparison of Overall Survival (OS) in HER2 conversion group.

Figure (2C)

Kaplan Meier curve shows comparison of Overall Survival (OS) in Tumor Phenotype Conversion group.

DOI: https://doi.org/10.2478/fco-2019-0021 | Journal eISSN: 1792-362X | Journal ISSN: 1792-345X
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Language: English
Page range: 3 - 11
Submitted on: Jun 14, 2019
Accepted on: Dec 11, 2019
Published on: May 2, 2021
Published by: Helenic Society of Medical Oncology
In partnership with: Paradigm Publishing Services
Keywords:
Breast cancer,
neoadjuvant chemotherapy,
concordance between ER,
PR,
HER2 neu,
prognosis
Related subjects:
Medicine,
Clinical medicine,
Internal medicine,
Haematology, oncology

© 2021 Heba F. Taha, Ola M. Elfarargy, Reham A. Salem, Doaa Mandour, Amira A. Salem, Mohamed Riad, published by Helenic Society of Medical Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Volume 12 (2021): Issue 1 (May 2021)
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