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. 2018 Feb 20;18(1):203.
doi: 10.1186/s12885-018-4101-7.

Breast cancer subtype discordance: impact on post-recurrence survival and potential treatment options

Peter F McAnena  1 , Andrew McGuire  1 , A Ramli  1 , C Curran  1 , C Malone  2 , R McLaughlin  2 , K Barry  2 , James A L Brown  3 , M J Kerin  1
Affiliations

Breast cancer subtype discordance: impact on post-recurrence survival and potential treatment options

Peter F McAnena et al. BMC Cancer. .

Erratum in

Abstract

Background: Recent studies have shown that breast cancer subtype can change from the primary tumour to the recurrence. Discordance between primary and recurrent breast cancer has implications for further treatment and ultimately prognosis. The aim of the study was to determine the rate of change between primary and recurrence of breast cancer and to assess the impact of these changes on survival and potential treatment options.

Methods: Patient demographics were collected on those who underwent surgery for breast cancer between 2001 and 2014 and had a recurrence with biopsy results and pathology scoring of both the primary and recurrence.

Results: One hundred thirty two consecutive patients were included. There were 31 (23.5%) changes in subtype. Discordance occurred most frequently in luminal A breast cancer (n = 20), followed by triple negative (n = 4), luminal B (n = 3) and HER2 (n = 3). Patients who changed from luminal A to triple negative (n = 18) had a significantly worse post-recurrence survival (p < 0.05) with overall survival approaching significance (p = 0.064) compared to concordant luminal A cases (n = 46). Overall receptor discordance rates were: estrogen receptor 20.4% (n = 27), progesterone receptor 37.7% (n = 50) and HER2 3% (n = 4). Loss of estrogen receptor and progesterone receptor was more common than gain (21 vs. 6 (p = 0.04) and 44 vs. 6 (p = 0.01) respectively). Nine patients (6.8%) gained receptor status potentially impacting treatment options.

Conclusion: Discordance in subtype and receptor status occurs between primary and recurrent breast cancer, ultimately affecting survival and potentially impacting treatment options.

Keywords: Breast cancer; Discordance; Post-recurrence survival; Subtype; Triple negative.

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Conflict of interest statement

Ethics approval and consent to participate

This study was conducted in accordance with the granted National University of Ireland Galway and University College Hospital Galway ethical approval. All patients had histologically confirmed breast cancer and all relevant clinic-pathological and demographic data were obtained from a prospectively maintained breast cancer database.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Cohort description. a. Total number of discordant cases and impact on treatment changes. b. Specific changes in subtype from primary to recurrence
Fig. 2
Fig. 2
Luminal (a) to triple negative (n = 18) vs. triple negative concordant (n = 46). A 10 year overall survival (p = 0.064). b 5 year post-recurrence survival (p < 0.05)
See this image and copyright information in PMC

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