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Prognosis of metastatic breast cancer subtypes: the hormone receptor/HER2-positive subtype is associated with the most favorable outcome

  • Epidemiology
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Abstract

Contrary to the situation in early breast cancer, little is known about the prognostic relevance of the hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) in metastatic breast cancer. The objectives of this study were to present survival estimates and to determine the prognostic impact of breast cancer subtypes based on HR and HER2 status in a recent cohort of metastatic breast cancer patients, which is representative of current clinical practice. Patients diagnosed with metastatic breast cancer between 2007 and 2009 were included. Information regarding patient and tumor characteristics and treatment was collected. Patients were categorized in four subtypes based on the HR and HER2 status of the primary tumor: HR positive (+)/HER2 negative (−), HR+/HER2+, HR−/HER2+ and triple negative (TN). Survival was estimated using the Kaplan–Meier method. Cox proportional hazards model was used to determine the prognostic impact of breast cancer subtype, adjusted for possible confounders. Median follow-up was 21.8 months for the 815 metastatic breast cancer patients included; 66 % of patients had the HR+/HER2− subtype, 8 % the HR−/HER2+ subtype, 15 % the TN subtype and 11 % the HR+/HER2+ subtype. The longest survival was observed for the HR+/HER2+ subtype (median 34.4 months), compared to 24.8 months for the HR+/HER2− subtype, 19.8 months for the HR−/HER2+ subtype and 8.8 months for the TN subtype (P < 0.0001). In the multivariate analysis, subtype was an independent prognostic factor, as were initial site of metastases and metastatic-free interval. The HR+/HER2+ subtype was associated with the longest survival after diagnosis of distant metastases.

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Acknowledgments

This work was supported by the Netherlands Organization for Health Research and Development (Grant Number ZonMw: 80-82500-98-8003).

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Maastricht University Medical Center, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands

    Dorien J. A. Lobbezoo, Roel J. W. van Kampen, Adri C. Voogd, Maaike de Boer & Vivianne C. G. Tjan-Heijnen

  2. Máxima Medical Center, Eindhoven, The Netherlands

    Dorien J. A. Lobbezoo & M. Wouter Dercksen

  3. Atrium Medical Center Parkstad, Heerlen, The Netherlands

    Franchette van den Berkmortel

  4. Jeroen Bosch Hospital, Den Bosch, The Netherlands

    Tineke J. Smilde

  5. VieCuri Medical Center, Venlo, The Netherlands

    Agnes J. van de Wouw

  6. Orbis Medical Center, Sittard, The Netherlands

    Frank P. J. Peters

  7. St Elisabeth Hospital, Tilburg, The Netherlands

    Johanna M. G. H. van Riel

  8. St Jans Hospital, Weert, The Netherlands

    Natascha A. J. B. Peters

  9. Radboud University Medical Center, Nijmegen, The Netherlands

    George F. Borm

Authors
  1. Dorien J. A. Lobbezoo
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  2. Roel J. W. van Kampen
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  3. Adri C. Voogd
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  4. M. Wouter Dercksen
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  5. Franchette van den Berkmortel
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  6. Tineke J. Smilde
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  7. Agnes J. van de Wouw
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  8. Frank P. J. Peters
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  9. Johanna M. G. H. van Riel
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  10. Natascha A. J. B. Peters
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  11. Maaike de Boer
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  12. George F. Borm
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  13. Vivianne C. G. Tjan-Heijnen
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Corresponding author

Correspondence to Vivianne C. G. Tjan-Heijnen.

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Lobbezoo, D.J.A., van Kampen, R.J.W., Voogd, A.C. et al. Prognosis of metastatic breast cancer subtypes: the hormone receptor/HER2-positive subtype is associated with the most favorable outcome. Breast Cancer Res Treat 141, 507–514 (2013). https://doi.org/10.1007/s10549-013-2711-y

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  • DOI: https://doi.org/10.1007/s10549-013-2711-y

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