Early versus late distant metastasis and adjuvant chemotherapy alone versus both radiotherapy and chemotherapy in molecular apocrine breast cancer

Oncotarget. 2016 Aug 2;7(31):48905-48917. doi: 10.18632/oncotarget.10211.

Abstract

As a new subtype of breast cancer, molecular apocrine breast cancer (MABC) is estrogen receptor (ER) and progesterone receptor (PR) negative expression, but androgen receptor (AR) positive expression. The prognostic significance and clinical biological behavior of MABC have remained unclear up to now. This study aimed to analysis the distant metastasis behavior and response to adjuvant radiotherapy and chemotherapy of MABC subgroup. The report showed that there were significant differences between early and late distant metastasizing tumors with respect to Ki67, epidermal growth factor receptor 2 (HER2) and vascular endothelial growth factor (VEGF) expressions by a retrospective analysis consisting of 410 invasive breast cancer patients, which included 205 MABC and 205 nonMABC cases. MABC subgroup metastasized earlier than nonMABC subgroup, and MABC showed a tendency for a higher metastasis rate in lung, liver and brain, but lower in bone. HER2-positive or VEGF-positive tumors were more inclined to develop bone metastasis within MABC subgroup. The survival rate was superior for patients undergone both adjuvant radiotherapy and chemotherapy than those undergone chemotherapy alone in nonMABC subgroup, but there was no significant difference in MABC subgroup. Our data suggested that MABC subgroup seemed to develop distant metastasis earlier than nonMABC subgroup, and patients with MABC indicated poor prognosis. This study might also provide a foundation for helping patients receive reasonable treatments according to molecular subtype.

Keywords: Pathology Section; androgen receptor; distant metastasis; molecular apocrine breast cancer; radiotherapy and chemotherapy; survival rate.

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Agents / pharmacology
  • Apocrine Glands / pathology
  • Brain Neoplasms / drug therapy
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / metabolism
  • Chemotherapy, Adjuvant / methods*
  • Disease-Free Survival
  • Estrogen Receptor alpha / metabolism
  • Female
  • Follow-Up Studies
  • Gene Expression Profiling
  • Gene Expression Regulation, Neoplastic*
  • Humans
  • Immunohistochemistry
  • Ki-67 Antigen / metabolism
  • Liver Neoplasms / drug therapy
  • Lung Neoplasms / drug therapy
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Metastasis
  • Prognosis
  • Radiotherapy / methods*
  • Receptor, ErbB-2 / metabolism
  • Receptors, Progesterone / metabolism
  • Retrospective Studies

Substances

  • Antineoplastic Agents
  • ESR1 protein, human
  • Estrogen Receptor alpha
  • Ki-67 Antigen
  • Receptors, Progesterone
  • ERBB2 protein, human
  • Receptor, ErbB-2