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. 2022 Apr;27(4):707-716.
doi: 10.1007/s10147-022-02115-x. Epub 2022 Jan 18.

The impact of hormone receptor on the clinical outcomes of HER2-positive breast cancer: a population-based study

Yiqun Han #  1 , Yun Wu #  1 , Hangcheng Xu  1 , Jiayu Wang  2 , Binghe Xu  3
Affiliations

The impact of hormone receptor on the clinical outcomes of HER2-positive breast cancer: a population-based study

Yiqun Han et al. Int J Clin Oncol. 2022 Apr.

Abstract

Background: To investigate the impact of hormone receptor (HR) on the clinicopathological characteristics and prognosis of human epidermal growth factor receptor 2 (HER2)-positive breast cancer.

Methods: Using the Surveillance, Epidemiology, and End Results database, we enrolled patients diagnosed with HER2-positive breast cancer between 2010 and 2016, which were successively assessed for eligibility and categorized into HR + /HER2 + and HR-/HER2 + subgroups. Clinicopathological characteristics were undergone comparative analyses with the baseline distinctions calibrated by propensity score matching, while the survival outcomes were compared using Kaplan-Meier method with log-rank tests.

Results: A total of 46,803 HER2-positive breast cancer patients were identified, of which 32,919 individuals were HR + /HER2 + subtype and 13,884 individuals were HR-/HER2 + subtype, respectively. Comparatively, HR + /HER2 + breast cancer presented a lower histological grade, a smaller tumor size, a lower nodal involvement, and a lower rate of de novo stage IV disease. Substantial heterogeneity was detected in the metastatic patterns of organ-specific involvement between the two subgroups with initial metastasis. Overall, patients with HR + /HER2 + tumors had increasingly favorable prognosis in terms of overall survival and breast cancer-specific survival than patients with the HR-/HER2 + subtype. However, this kind of tendency exhibited disparities associated with HR-specific subtypes based on estrogen receptor (ER) and progesterone receptor (PgR) status, in which ER-/PgR + tended to present the worst prognosis.

Conclusion: This study revealed profound heterogeneity associated with HR status in the clinical outcomes of HER2-positive breast cancer regarding clinicopathological features, metastatic patterns, and prognosis. Prospective studies to optimize therapeutic strategies for HER2-positive subgroups are warranted.

Keywords: Breast cancer; Clinical features; HER2-positive; Hormone receptor; Prognosis.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Comparative analysis of OS (a) and BCSS (b) between HR + /HER2 + and HR-/HER2 + subgroups. HR hormone receptor, HER2 human epidermal growth factor receptor 2, OS overall survival, BCSS breast cancer-specific survival
Fig. 2
Fig. 2
Comparative analysis of OS (a) and BCSS (b) associated with ER and PgR status. ER estrogen receptor, PgR progesterone receptor, OS overall survival, BCSS breast cancer-specific survival
See this image and copyright information in PMC

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