Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Aug;140(3):463-73.
doi: 10.1007/s10549-013-2647-2. Epub 2013 Jul 31.

Molecular subtypes, histopathological grade and survival in a historic cohort of breast cancer patients

M J Engstrøm  1 , S Opdahl, A I Hagen, P R Romundstad, L A Akslen, O A Haugen, L J Vatten, A M Bofin
Affiliations

Molecular subtypes, histopathological grade and survival in a historic cohort of breast cancer patients

M J Engstrøm et al. Breast Cancer Res Treat. 2013 Aug.

Abstract

Molecular subtyping of breast cancer may provide additional prognostic information regarding patient outcome. However, its clinical significance remains to be established. In this study, the main aims were to discover whether reclassification of breast cancer into molecular subtypes provides more precise information regarding outcome compared to conventional histopathological grading and to study breast cancer-specific survival in the different molecular subtypes. Cases of breast cancer occurring in a cohort of women born between 1886 and 1928 with long-term follow-up were included in the study. Tissue microarrays were constructed from archival formalin-fixed, paraffin-embedded tissue from 909 cases. Using immunohistochemistry and in situ hybridisation as surrogates for gene expression analyses, all cases were reclassified into the following molecular subtypes: Luminal A; Luminal B (HER2-); Luminal B (HER2+); HER2 subtype; Basal phenotype; and five negative phenotype. Kaplan-Meier survival curves and Cox proportional hazards models were used in the analyses. During the first 5 years after diagnosis, there were significant differences in prognosis according to molecular subtypes with the best survival for the Luminal A subtype and the worst for HER2 and five negative phenotype. In this historic cohort of women with breast cancer, differences in breast cancer-specific survival according to subtype occur almost exclusively amongst the histopathological grade 2 tumours. From 5 years after time of diagnosis until the end of follow-up, there appears to be no difference in survival according to molecular subtype or histopathological grade.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Study population
Fig. 2
Fig. 2
Classification algorithm for molecular subtyping
Fig. 3
Fig. 3
Distribution of grade in percent according to subtype
Fig. 4
Fig. 4
Kaplan–Meier plot. Breast cancer-specific survival according to molecular subtypes. P-value from log-rank test of differences in BCSS was <0.0001
Fig. 5
Fig. 5
Kaplan–Meier plot. Breast cancer-specific survival according to grade. P-value from log-rank test of differences in BCSS was 0.0001
See this image and copyright information in PMC

References

    1. Bartlett JM, Starczynski J, Atkey N, Kay E, O’Grady A, Gandy M, Ibrahim M, Jasani B, Ellis IO, Pinder SE, Walker RA. HER2 testing in the UK: recommendations for breast and gastric in situ hybridisation methods. J Clin Pathol. 2011;64:649–653. doi: 10.1136/jcp.2011.089847. - DOI - PubMed
    1. Bhargava R, Beriwal S, McManus K, Dabbs DJ. CK5 is more sensitive than CK5/6 in identifying the “basal-like” phenotype of breast carcinoma. Am J Clin Pathol. 2008;130:724–730. doi: 10.1309/AJCP3KFF1LTYWQIY. - DOI - PubMed
    1. Bloom HJ, Richardson WW. Histological grading and prognosis in breast cancer; a study of 1409 cases of which 359 have been followed for 15 years. Br J Cancer. 1957;11:359–377. doi: 10.1038/bjc.1957.43. - DOI - PMC - PubMed
    1. Blows FM, Driver KE, Schmidt MK, Broeks A, van Leeuwen FE, Wesseling J, Cheang MC, Gelmon K, Nielsen TO, Blomqvist C, Heikkila P, Heikkinen T, Nevanlinna H, Akslen LA, Begin LR, Foulkes WD, Couch FJ, Wang X, Cafourek V, Olson JE, Baglietto L, Giles GG, Severi G, McLean CA, Southey MC, Rakha E, Green AR, Ellis IO, Sherman ME, Lissowska J, Anderson WF, Cox A, Cross SS, Reed MW, Provenzano E, Dawson SJ, Dunning AM, Humphreys M, Easton DF, Garcia-Closas M, Caldas C, Pharoah PD, Huntsman D. Subtyping of breast cancer by immunohistochemistry to investigate a relationship between subtype and short and long term survival: a collaborative analysis of data for 10,159 cases from 12 studies. PLoS Med. 2010;7:e1000279. doi: 10.1371/journal.pmed.1000279. - DOI - PMC - PubMed
    1. Caldarella A, Puliti D, Crocetti E, Bianchi S, Vezzosi V, Apicella P, Biancalani M, Giannini A, Urso C, Zolfanelli F, Paci E. Biological characteristics of interval cancers: a role for biomarkers in the breast cancer screening. J Cancer Res Clin Oncol. 2012 - PMC - PubMed

Publication types

MeSH terms