Tuesday, October 20, 2020

Distribution of tumor subtypes in bilateral breast cancer: Comparison between synchronous and metachronous cancer

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Distribution of tumor subtypes in bilateral breast cancer: Comparison between synchronous and metachronous cancer

The pattern in distribution of breast cancer subtypes was different between SBC and MBC. Patients with MBC were more likely to be young, have a family history of cancer and have TN subtype than SBC.


Abstract

Aim

This study was performed to evaluate patterns of breast cancer subtypes in Korean patients with synchronous (SBC) or metachronous bilateral breast cancer (MBC).

Methods

We retrospectively reviewed records of 302 patients with SBC (n = 161) or MBC (n = 141) who received curative surgery at our hospital between 1995 and 2013. Expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) was determined by immunohistochemistry (IHC) staining. We categorized breast cancers into the following subtypes: ER+ or PR+, HER2− (i.e., luminalA); ER+ or PR+, HER2+ (i.e., luminalB HER2+); ER−, PR− and HER2+ (i.e., HER2‐enriched); ER−, PR− and HER2− (i.e., triple negative, TN).

Results

More patients with MBC were ≤40 years at the time of breast cancer diagnosis than patients with SBC (34.6% vs. 19.3%, P < 0.01). The proportion of subtypes in SBC and MBC were as follows: luminalA, 65.8% vs. 45.0%; luminalB, HER2+, 9.0% vs. 8.5%; HER2‐enriched, 4.1% vs. 12.1%; and TN, 11.2% vs. 31.2%, respectively (P < 0.01). The 10‐year overall survival rate in patients with SBC and MBC was 89.0% and 93.6%, respectively. The 10‐year disease‐free survival rate in patients with SBC and MBC was 79.6% and 80.9%, respectively. Locoregional recurrence was found in 2.5% of patients with SBC and 9.9% of patients with MBC. Distant metastasis occurred in 8.7% of patients with SBC and 4.9% of patients with MBC.

Conclusion

The distribution of breast cancer subtypes was different between SBC and MBC. TN‐subtype was profoundly more frequent in MBC whereas luminal‐subtype was most frequently found among SBC.

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