Characterization of Weakly Hormone Receptor (HR)-Positive,HER2-Negative Breast Cancer and Current Treatment Strategies |
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| Affiliation: | 1. Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI;2. Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI;1. The University of Cambridge, The Old Schools, Cambridge, United Kingdom;2. Cambridge University Hospitals, Breast Unit, Cambridge Biomedical Research Centre, Cambridge, United Kingdom;1. Health data and assessment department, Survey Data Science and Assessment Division, National cancer institute, Boulogne-Billancourt, France;2. Loire-Atlantique/Vendée Cancer Registry, Nantes, France;3. CERPOP, Université de Toulouse, Toulouse, France;4. Santé Publique France, French National Public Health Agency, Saint-Maurice, France;5. Public health division, National cancer institute, Boulogne-Billancourt, France;6. National cancer Institute, Boulogne-Billancourt, France;7. Survey Data Science and Assessment Division, National cancer institute, Boulogne-Billancourt, France;8. Aix Marseille Univ, INSERM, IRD, Economics and Social Sciences Applied to Health & Analysis of Medical Information (SESSTIM), Marseille, France;1. Department of Radiation Oncology, Dana-Farber Cancer Institute, Harvard University, Boston, MA;2. Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, OH;3. Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ;4. Department of Surgery, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ;1. Division of Health Services Research, National Cancer Center, Chuo-ku, Tokyo, Japan;2. Department of Medical Oncology, St. Luke''s International Hospital, Chuo-ku, Tokyo, Japan;1. Cancer Biology Laboratory, Department of Biochemistry and Bioinformatics, GITAM School of Science, GITAM (Deemed to be University), Visakhapatnam, Andhra Pradesh, India;2. Department of Bioscience and Biotechnology, Banasthali University, Vanasthali, Rajasthan, India;3. Department of Hematology and Oncology, School of medicine, University of Alabama, Birmingham, Birmingham, AL;1. Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI;2. Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI;3. Alvin J. Siteman Cancer Center, Washington University School of Medicine, St Louis, Missouri.;4. Medical College of Wisconsin Cancer Center, Milwaukee, WI;5. University of Wisconsin-Milwaukee Zilber School of Public Health, Milwaukee, WI |
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| Abstract: | BackgroundHormone receptor (HR) and human epidermal growth factor receptor-2 (HER2) status is critical for determining management of breast cancer. Previous reports of small cohorts with weak HR-positive (HR+)/HER2-negative (HER2-) disease showed similar rates of pathologic complete response (pCR) following neoadjuvant chemotherapy (NAC) as triple negative breast cancer (TNBC). This study aims to further characterize this group, focusing on pCR rates following NAC.Patients and MethodsPatients with stage I-III, HR+/HER2- breast cancer were identified using the University of Wisconsin Hospital Cancer Registry. Medical records were reviewed for demographics, tumor characteristics with quantification level of estrogen and progesterone receptor (≤33%), treatment, and follow-up data.ResultsData was reviewed from 2,900 patients and a total of 64 patients met inclusion criteria. Eighty percent received chemotherapy, about half with NAC (n = 30, 48%). Of 28 patients who received NAC followed by breast and axillary surgery, 12 (43%; 95% CI 25%-63%) had pCR (ypT0/Tis/ypN0). Of the 11 patients who had biopsyproven nodal disease at diagnosis and NAC followed by axillary surgery, 7 (64%, 95% CI 31%-89%) patients had pCR at the axilla. Only one patient with pCR developed recurrent disease. For those that recurred, median time to recurrence was 13.6 (5.6-48.7) months.ConclusionsBreast cancers that are HER2- and weakly HR+ treated with NAC demonstrated pCR rate more similar to TNBC than breast cancers that are strong HR+. Neoadjuvant approaches may improve pCR rates, which provides important prognostic information. Clinical trials should be developed to focus on this unique patient cohort. |
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