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Progesterone receptor loss identifies hormone receptor-positive and HER2-negative breast cancer subgroups at higher risk of relapse: a retrospective cohort study

Authors Sun J, Wu S, Li F, Lin H, He Z

Received 20 October 2015

Accepted for publication 1 February 2016

Published 21 March 2016 Volume 2016:9 Pages 1707—1713


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Dekuang Zhao

Peer reviewer comments 2

Editor who approved publication: Professor Daniele Santini

Jia-Yuan Sun,1,* San-Gang Wu,2,* Feng-Yan Li,1 Huan-Xin Lin,1 Zhen-Yu He1

1Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, People’s Republic of China; 2Department of Radiation Oncology, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, People’s Republic of China

*These authors contributed equally to this work

Background: To assess the prognostic value of progesterone receptor (PR) expression in patients with hormone receptor-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer subgroups.
Methods: A retrospective review of breast cancer patients who underwent mastectomy or breast-conserving surgery between January 1998 and December 2007 was performed. The prognostic impact of PR status on disease-free survival (DFS) was analyzed.
Results: Of the 1,301 patients included in this study, the median follow-up time was 64 months, and the median age was 46 years. There were 18.4% of patients (n=219) with PR negative (PR–) cancer. Women with PR– breast cancer were more likely to be postmenopausal (P<0.001) and have pN3 stage (P=0.031) and Stage III (P=0.049) cancer. Cox regression univariate and multivariate analysis showed that PR status was a significant prognostic factor for DFS. Patients with PR– status had poorer DFS (hazard ratio =1.626, 95% confidence interval =1.060–2.497, P=0.026). The 5-year DFS for patients with PR– and PR+ breast cancer was 79.4% and 86.2%, respectively, and the 8-year DFS for patients with PR– and PR+ breast cancer was 69.6% and 78.1%, respectively (P=0.012). A significant difference in DFS was observed between PR– and PR+ disease in patients with node-negative cancer, but was not for patients with lymph node metastasis (P=0.242). In premenopausal patients, DFS varied significantly by PR status (P=0.049). A marginally significant difference in DFS between the PR– and PR+ disease was seen in postmenopausal patients (log rank P=0.065).
Conclusion: Lack of PR expression is associated with worse survival in patients with hormone receptor-positive and HER2-negative breast cancer subgroups.

Keywords: breast cancer, breast cancer subtype, progesterone receptor, prognosis, recurrence

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