Lymph node involvement in immunohistochemistry-based molecular classifications of breast cancer

Nicholas K. Howland, Teryn D. Driver, Michael P. Sedrak, Xianfeng Wen, Wenli Dong, Sandra Hatch, Mahmoud A. Eltorky, Celia Chao

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Prognosis and treatment options differ for each molecular subtype of breast cancer, but risk of regional lymph node (LN) metastasis for each subtype has not been well studied. Since LN status is the most important predictor for prognosis, the aim of this study is to investigate the propensity for LN metastasis in each of the five breast cancer molecular subtypes. Methods: Under an institutional review boardeapproved protocol, we retrospectively reviewed the charts of all pathologically confirmed breast cancer cases from January 2004 to June 2012. Five subtypes were defined as luminal A (hormone receptor positive, Ki-67 low), luminal B (hormone receptor positive, Ki-67 high), luminal human epidermal growth factor receptor 2 (HER2), HER2-enriched (hormone receptor negative), and triple negative (TN). Results: A total of 375 patients with complete data were classified by subtype: 95 (25.3%) luminal A, 120 (32%) luminal B, 69 (18.4%) luminal HER2, 26 (6.9%) HER2-enriched, and 65 (17.3%) TN. On univariate analysis, age (&l7;50), higher tumor grade, HER2+ status, tumor size, and molecular subtype were significant for LN positivity. Molecular subtype correlated strongly with tumor size (c2; P= 0.0004); therefore, multivariable logistic regression did not identify molecular subtype as an independent variable to predict LN positivity. Conclusions: Luminal A tumors have the lowest risk of LN metastasis, whereas luminal HER2 subtype has the highest risk of LN metastasis. Immunohistochemical-based molecular classification can be readily performed and knowledge of the factors that affect LN status may help with treatment decisions.

Original languageEnglish (US)
Pages (from-to)697-703
Number of pages7
JournalJournal of Surgical Research
Volume185
Issue number2
DOIs
StatePublished - Dec 2013

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Lymph Nodes
Immunohistochemistry
Breast Neoplasms
Neoplasm Metastasis
Hormones
Neoplasms
human ERBB2 protein
Logistic Models
Therapeutics

Keywords

  • Immunohistochemistry
  • Molecular subtypes of breast cancer

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Lymph node involvement in immunohistochemistry-based molecular classifications of breast cancer. / Howland, Nicholas K.; Driver, Teryn D.; Sedrak, Michael P.; Wen, Xianfeng; Dong, Wenli; Hatch, Sandra; Eltorky, Mahmoud A.; Chao, Celia.

In: Journal of Surgical Research, Vol. 185, No. 2, 12.2013, p. 697-703.

Research output: Contribution to journalArticle

Howland, Nicholas K. ; Driver, Teryn D. ; Sedrak, Michael P. ; Wen, Xianfeng ; Dong, Wenli ; Hatch, Sandra ; Eltorky, Mahmoud A. ; Chao, Celia. / Lymph node involvement in immunohistochemistry-based molecular classifications of breast cancer. In: Journal of Surgical Research. 2013 ; Vol. 185, No. 2. pp. 697-703.
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N2 - Background: Prognosis and treatment options differ for each molecular subtype of breast cancer, but risk of regional lymph node (LN) metastasis for each subtype has not been well studied. Since LN status is the most important predictor for prognosis, the aim of this study is to investigate the propensity for LN metastasis in each of the five breast cancer molecular subtypes. Methods: Under an institutional review boardeapproved protocol, we retrospectively reviewed the charts of all pathologically confirmed breast cancer cases from January 2004 to June 2012. Five subtypes were defined as luminal A (hormone receptor positive, Ki-67 low), luminal B (hormone receptor positive, Ki-67 high), luminal human epidermal growth factor receptor 2 (HER2), HER2-enriched (hormone receptor negative), and triple negative (TN). Results: A total of 375 patients with complete data were classified by subtype: 95 (25.3%) luminal A, 120 (32%) luminal B, 69 (18.4%) luminal HER2, 26 (6.9%) HER2-enriched, and 65 (17.3%) TN. On univariate analysis, age (&l7;50), higher tumor grade, HER2+ status, tumor size, and molecular subtype were significant for LN positivity. Molecular subtype correlated strongly with tumor size (c2; P= 0.0004); therefore, multivariable logistic regression did not identify molecular subtype as an independent variable to predict LN positivity. Conclusions: Luminal A tumors have the lowest risk of LN metastasis, whereas luminal HER2 subtype has the highest risk of LN metastasis. Immunohistochemical-based molecular classification can be readily performed and knowledge of the factors that affect LN status may help with treatment decisions.

AB - Background: Prognosis and treatment options differ for each molecular subtype of breast cancer, but risk of regional lymph node (LN) metastasis for each subtype has not been well studied. Since LN status is the most important predictor for prognosis, the aim of this study is to investigate the propensity for LN metastasis in each of the five breast cancer molecular subtypes. Methods: Under an institutional review boardeapproved protocol, we retrospectively reviewed the charts of all pathologically confirmed breast cancer cases from January 2004 to June 2012. Five subtypes were defined as luminal A (hormone receptor positive, Ki-67 low), luminal B (hormone receptor positive, Ki-67 high), luminal human epidermal growth factor receptor 2 (HER2), HER2-enriched (hormone receptor negative), and triple negative (TN). Results: A total of 375 patients with complete data were classified by subtype: 95 (25.3%) luminal A, 120 (32%) luminal B, 69 (18.4%) luminal HER2, 26 (6.9%) HER2-enriched, and 65 (17.3%) TN. On univariate analysis, age (&l7;50), higher tumor grade, HER2+ status, tumor size, and molecular subtype were significant for LN positivity. Molecular subtype correlated strongly with tumor size (c2; P= 0.0004); therefore, multivariable logistic regression did not identify molecular subtype as an independent variable to predict LN positivity. Conclusions: Luminal A tumors have the lowest risk of LN metastasis, whereas luminal HER2 subtype has the highest risk of LN metastasis. Immunohistochemical-based molecular classification can be readily performed and knowledge of the factors that affect LN status may help with treatment decisions.

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