Background: Knowledge is limited about prognostic significance of breast cancer subtypes among women with small invasive node-negative breast tumors. Methods: We explored patterns of recurrence in 1,715 patients with pT1mic/T1a/T1b, node-negative operable breast cancer according to four immunohistochemically defined tumour subtypes: (i) Luminal A (ER-positive, PgR-positive, HER2-negative and Ki-67<14%); (ii) Luminal B (ER-positive and/or PgR-positive, HER2-positive and/or Ki-67≥14%); (iii) HER2-positive, both endocrine receptors absent; and (iv) triple negative. Results: At multivariate analysis, patients with the triple-negative subtype showed an increased risk of loco-regional relapse (HR 3.37; 95%CI: 1.31-8.70) and breast cancer related events (HR 2.17; 95%CI: 1.04-4.53). Overall, Luminal B was not associated with a significant higher risk of recurrence compared with Luminal A, while the subgroup of Lumimal B with HER2-positive has a 2-fold risk of reduced breast cancer survival compared with Luminal A subtype. HER2 was the only subtype with a statistically significant increased risk of loco-regional relapse (HR, 4.77; 95%CI: 1.65-13.8), distant metastases, and reduced breast cancer related event-free survival and overall survival (HR, 2.95; 95%CI: 1.07-8.10) if compared with the Luminal A subtype, at multivariate analysis. Conclusions: Patients with small size, node-negative breast cancer are at higher risk of relapse if with HER2-positive endocrine receptor absent or triple-negative disease. Multivariate analysis.
Mastropasqua, M. G.
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