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Immunophenotypic Conversion between Primary and Relapse Breast Cancer and its Effects on Survival
Isabel Blancas1,2,3,4, Antonio Jesús Muñoz-Serrano5, Marta Legerén6
1Department of Medicine, School of Medicine, University of Granada, Granada, Spain, iblancas@ugr.es.
Gynecologic and Obstetric Investigation
|April 15, 2020
Summary
Breast cancer characteristics can change upon recurrence. Estrogen receptor (ER) or progesterone receptor (PR) status changes in metastatic disease (MD) impact progression-free survival (PFS), highlighting the importance of relapse biopsies for accurate prognosis and treatment.
Area of Science:
- Oncology
- Pathology
- Medical Diagnostics
Background:
- Breast cancer recurrence can exhibit altered receptor expression (ER, PR, HER2) and proliferation markers (Ki-67) compared to the primary tumor.
- Understanding these changes is crucial for determining their prognostic significance.
Purpose of the Study:
- To investigate the changes in oestrogen receptor (ER), progesterone receptor (PR), HER2, and Ki-67 between primary breast cancer and its recurrence.
- To evaluate the prognostic implications of these immunophenotype changes on survival outcomes.
Main Methods:
- Retrospective analysis of 45 breast cancer patients with relapsed biopsies, categorized into local relapse (LR) and metastatic disease (MD) groups.
- Assessment of immunophenotype conversion rates and its correlation with relapse-free survival (RFS), progression-free survival (PFS), and overall survival (OS).
Main Results:
- Conversion rates observed: Ki-67 (34.8%), ER (20%), PR (20%), HER2 (15.6%).
- In the metastatic disease (MD) group, ER+ status correlated with longer PFS (24.7 months) compared to ER- (9.3 months), and PR+ with longer PFS (25.1 months) versus PR- (12.7 months).
- No significant differences in RFS or OS were found in the local relapse (LR) group based on immunophenotype; OS in the MD group also showed no significant immunophenotype-related differences.
Conclusions:
- Breast cancer immunophenotype can change during disease progression.
- Variations in ER and PR status in metastatic disease hold prognostic value for PFS.
- Biopsy of recurrent disease is recommended to guide accurate prognosis and treatment decisions.
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