Related Experiment Video
Updated: Aug 1, 2025
Optimization of a Multiplex RNA-based Expression Assay Using Breast Cancer Archival Material
Published on: August 1, 2018
The changes of subtype markers between first and second primary breast cancers
Chenyang Li1, Zhangyan Lyu1, Zhipeng Wang1
1Department of Epidemiology and Biostatistics, Key Laboratory of Molecular Cancer Epidemiology, Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin's Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Changes in breast cancer subtype markers like ER, PR, and HER2 are common between first and second primary breast cancers. These marker shifts significantly impact patient survival, highlighting the need for routine biopsies for effective treatment.
Area of Science:
- Oncology
- Cancer Research
- Clinical Pathology
Background:
- Previous research has explored subtype marker changes (ER, PR, HER2) in various clinical contexts.
- However, such investigations were lacking for second primary breast cancer (SPBC) following a first primary breast cancer (FPBC).
Purpose of the Study:
- To investigate the changes in estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) subtype markers between FPBC and SPBC.
- To determine the prognostic implications of these marker changes and identify potential influential factors.
Main Methods:
- Analysis of 3777 patients with complete subtype marker data for both FPBC and SPBC from the Surveillance, Epidemiology, and End Results (SEER) Program.
- Evaluation of marker change rates, including gains and losses, and their association with patient mortality using multivariate competing risk analyses.
Main Results:
- Significant overall change rates observed for ER (23.0%), PR (35.0%), and HER2 (18.3%) between FPBC and SPBC.
- Loss of ER and PR was associated with increased mortality, while gain of ER and PR was associated with decreased mortality.
- Loss of HER2 was linked to decreased mortality, whereas HER2 gain showed no significant prognostic association. First primary breast cancer HER2 status, chemotherapy, and radiotherapy influenced ER/PR changes.
Conclusions:
- Substantial proportions of patients exhibit changes in breast cancer subtype markers between primary diagnoses, carrying significant prognostic implications.
- Routine biopsies are recommended for SPBC patients to guide personalized therapy management based on updated marker status.
