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Association between PIK3CA activating mutations and outcomes in early-stage invasive lobular breast carcinoma treated with adjuvant systemic therapy Cover

Association between PIK3CA activating mutations and outcomes in early-stage invasive lobular breast carcinoma treated with adjuvant systemic therapy

Open Access
|Jun 2023

Figures & Tables

FIGURE 1.

Consort diagram.
Consort diagram.

FIGURE 2.

Kaplan-Meier graph showing association between PIK3CA mutation and overall survival.
Kaplan-Meier graph showing association between PIK3CA mutation and overall survival.

FIGURE 3.

Kaplan-Meier graph showing association between PIK3CA mutation and distant metastasis-free survival
Kaplan-Meier graph showing association between PIK3CA mutation and distant metastasis-free survival

Simple Cox proportional hazards model for DMFS in the PIK3CA mutated patient cohort

CharacteristicHR95% CIAdj p
Age0.990.96–1.021.0
Duration of TAM0.920.75–1.141.0
Duration of AIs1.070.90–1.281.0

Distribution of systemic therapy in all patients and according to PIK3CA mutation status

Systemic therapyAll ptsN (%)PIK3CA mutated ptsN (%)PIK3CA non-mutated ptsN (%)
None12 (3)5 (3)7 (3)
ET only249 (68)115 (70)134 (67)
ChT only13 (4)5 (3)8 (4)
ET and ChT91 (25)39 (24)52 (26)
None ET25 (7)10 (6)15 (7)
ET with TAM106 (29)45 (27)61 (30)
ET with AIs127 (35)54 (33)73 (37)
Sequence TAM-AI107 (29)55 (34)52 (26)
Median duration (range) of ET5 (0.2–16.7)5 (0.4–16.7)5 (0.2–11.2)

Advanced Cox proportional hazards model for OS in the PIK3CA mutated patient cohort

CharacteristicHR95% CIAdj p
Age1.051.02–1.080.014
Tumor size1.380.90–2.100.84
Grade
   G1Ref
   G21.410.59–3.381.0
   G35.521.67–18.180.04
Ki-670.940.72–1.221.0
PR10.99–1.011.0
PIK3CA status
  Other than exon 20Ref
  Only exon 201.320.79–2.211.0
No. of positive axillary LNs1.581.32–1.88< 0.001
Duration of TAM0.680.55–0.860.01
Duration of AI0.730.60–0.880.01

Characteristics of the included patients and their tumors

CharacteristicAll patients (n = 365; 100%)PIK3CA mutated (n = 164; 45%)PIK3CA non-mutated (n = 201; 55%)
Median age (range) (yrs)62.8 (33–90)63.162.4
Median tumor size (mm)211921
Nodal status
   N0209 (57)100 (61)109 (54)
   N184 (23)37 (22)47 (23)
   N226 (7)1 (7)15 (8)
   N346 (13)16 (10)30 (15)
Tumor grade
   G152 (14)20 (12)32 (16)
   G2270 (74)134 (82)136 (68)
   G343 (12)10 (6)33 (16)
IHC* subtype
   ER+/PR+/HER2−299 (82)136 (46)159 (54)
   ER+/PR−/HER2−39 (11)14 (36)25 (64)
   HER2 +20 (6)9 (45)11 (55)
   ER−/PR−/HER2−7 (2)2 (29)5 (71)
Median Ki-67 (range) (%)3 (1–50)2.5 (1–50)3 (140)
Mitotic score
   M1284 (78)138 (84)146 (73)
   M255 (15)19 (12)36 (18)
   M326 (7)7 (4)19 (9)
Presence of LVI24 (7)4 (2)20 (10)
Median TILs (range) (%)3 (150)33
Median follow-up time (range) (yrs)10.8 (0.118.6)10.810.7

Advanced Cox proportional hazards model for DMFS in the PIK3CA mutated patient cohort

CharacteristicHR95% CIAdj p
Age1.010.97–1.051.0
Tumor size0.990.57–1.711.0
Grade
   G1Ref
   G20.910.26–3.221.0
   G31.030.16–6.831.0
Ki-671.350.93–1.951.0
PR10.99–1.021.0
PIK3CA status
   Other than exon 20Ref
   Only exon 202.191.01–4.800.582
No. of positive axillary LNs1.641.30–2.06< 0.001
Duration of TAM1.020.81–1.291.0
Duration of AIs1.060.87–1.281.0

Simple Cox proportional hazards model for OS in the PIK3CA mutated patient cohort

CharacteristicHR95% CIAdj p
Age1.051.02–1.07< 0.001
Duration of TAM0.730.61–0.880.002
Duration of AIs0.790.67–0.930.005
DOI: https://doi.org/10.2478/raon-2023-0027 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099
Language: English
Page range: 220 - 228
Submitted on: Feb 13, 2023
Accepted on: May 18, 2023
Published on: Jun 21, 2023
Published by: Association of Radiology and Oncology
In partnership with: Paradigm Publishing Services
Publication frequency: 4 times per year

© 2023 Domen Ribnikar, Valentina Jeric Horvat, Ivica Ratosa, Zachary W Veitch, Biljana Grcar Kuzmanov, Srdjan Novakovic, Erik Langerholc, Eitan Amir, Bostjan Seruga, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution 4.0 License.