Abstract P1-07-12: Prognosis of clinico-pathological breast cancer subtypes in routine clinical care
Authors: Hennigs A , Heil J , Gondos A , Riedel F , Marme F , Sinn H-P , Schirmacher P , Kauczor H-U , Debus J , Golatta M , Schtz F , Sohn C , Schneeweiss A 
Published: May 2016

Background / Aim: To analyze oncological outcome of breast cancer (BC) subtypes in routine clinical care in specialized breast care units (BCU).

Patients and methods: A prospectively followed cohort of 4110 female cases with primary, non-bilateral, non-metastatic BC treated between 01.01.2003 and 31.12.2012 has been analyzed for the whole cohort and separately for the five routinely used clinico-pathological subtypes (i.e. Luminal A, Luminal B (=Her2 neg.), Luminal B (=Her2 pos.), HER-2, triple negative). The median follow-up of the cohort was 51 month. We calculated estimates for local control rate (LCR), disease-free survival (DFS), distant disease-free survival (DDFS), overall survival (OS) and relative overall survival (ROS).

5 year outcome results referred to 5 different endpoints (using Kaplan-Meier method) of all patients with primary, non-metastatic, non-bilateral breast cancer treated at Heidelberg Breast Care Unit between 01.01.2003 and 31.12.2012 All patients (including in-situ)Patients with invasive cancer (excluding in-situ) n=4102 (including 499 in-situ cases)n = 3603LCR [%] (95% CI)96.1 (95.6 ; 96.6)96.1 (95.7 ; 96.5)DFS [%] (95% CI)85.0 (84.2 ; 85.8)83.7 (82.8 ; 84.6)DDFS [%] (95% CI)86.9 (86.1 ; 87.7)85.7 (84.8 ; (86.6)OS [%] (95% CI)91.3 (90.5 ; 92.2)90.5 (89.6 ; 91.4)ROS [%] (95% CI)95.5 (94.3 ; 96.7)94.7 (93.4 ; 96.0)CI, confidence interval; LCR, local recurrence rate; DFS, disease-free survival; DDFS, distant disease-free survival; OS, observed overall survival; ROS, relative (age adjusted) overall survival

Outcome results referred to 5 different endpoints (using Kaplan-Meier method) according to clinico-pathological tumor subtype or in-situ tumor. Results in percent at 5 years (95% CI).invasive cancer (n = 34541) Lum A-likeLum B1-likeLum B2-likeHER2+Triple negativeCIS (n = 499)LCR [%] (95% CI)99.1 (98.7 ; 99.5)95.2 (-)**95.0 (86.3 ; 100)90.5 (-)89.6 (87.1 ; 92.1)96.2 (94.3 ; 98.1)DFS [%] (95% CI)92.2 (90.9 ; 93.5)80.1 (78.6 ; 81.6)79.0 (71.0 ; 86.0)77.0 (-)69.1 (66.4 ; 71.8)93.0 (91.3 ; 94.7)DDFS [%] (95% CI)92.9 (91.6 ; 94.2)82.2 (80.5 ; 83.9)82.8 (76.5 ; 89.1)83.3 (-)72.2 (70.7 ; 73.7)95.6 (94.4 ; 96.8)OS [%] (95% CI)95.1 (94.1 ; 96.1)88.7 (86.6 ; 90.8)92.5 (87.5 ; 97.5)85.6 (79.9 ; 91.3)78.5 (76.4 ; 80.6)96.9 (95.2 ; 98.6)ROS [%] (95% CI)100.0 (98.5 ; 100)93.4 (90.7 ; 96.1)96.0 (91.2 ; 100)88.8 (81.4 ; 96.2)80.1 (75.1 ; 85.1)100.0 (97.8 ; 100)

Results: LCR, DFS, DDFS, OS and ROS over 5 years for the whole cohort of invasive cases were 96.1%, 83.7%, 85.7%, 90.5% and 94.7%, respectively. Luminal A tumors were the most frequent (44.7%) and showed the best outcome with LCR, OS and ROS over 5 years at 99.1%, 95.1% and 100.0%, respectively; while triple negative tumors presented the poorest outcome with LCR, OS and ROS over 5 years at 89.6%, 78.5% and 80.1%, respectively.

Conclusions: This outcome analysis of a large cohort of patients with primary BC diagnosed, treated and prospectively followed on a routine basis at a specialized BCU in Germany confirmed general and detailed clinico-pathological subtype outcome data of clinical trials.

Citation Format: Hennigs A, Heil J, Gondos A, Riedel F, Marme F, Sinn H-P, Schirmacher P, Kauczor H-U, Debus J, Golatta M, Schtz F, Sohn C, Schneeweiss A. Prognosis of clinico-pathological breast cancer subtypes in routine clinical care. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-07-12.