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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
Open AccessArticle

Outcomes of her2-positive Early-Stage Breast Cancer in the Trastuzumab Era: A Population-Based Study of Canadian Patients

1
Department of Medicine, University of Toronto, Toronto, ON, Canada
2
Department of Psychiatry, University of Toronto, Toronto, ON, Canada
3
Department of Medicine, McMaster University–Waterloo Campus, Kitchener, ON, Canada
4
Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
5
Department of Medicine, Division of Medical Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2013, 20(6), 539-545; https://doi.org/10.3747/co.20.1523
Received: 4 September 2013 / Revised: 9 October 2013 / Accepted: 5 November 2013 / Published: 1 December 2013
Breast cancer is heterogenous, with variable expression of the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Overexpression of HER2 is generally considered a negative prognostic feature, but whether outcomes for HER2-positive early breast cancer remain different from those for other subtypes in the era of trastuzumab-based adjuvant therapy is unknown. Methods: Using a retrospective chart review, we compared overall survival (OS) and relapse-free survival (RFS) in 3 groups of patients with early-stage breast cancer: ER-positive or PR-positive (or both) and HER2-negative [“hormone receptor–positive” (HR+)]; HER2-positive (HER2+); and ER-negative, PR-negative, and HER2-negative [“triple-negative” (TN)]. Results: In the 503 charts analyzed (332 HR+, 94 HER2+, 77 TN), the 5-year OS and RFS were, respectively, 94.2% and 87.2% for HR+ patients, 88.6% and 74.9% for HER2+ patients, and 85.4% and 76.2% for TN patients. On multivariate analysis, the OS for the HER2+ subtype was similar to that for the HR+ subtype (hazard ratio:1.07; 95% confidence interval: 0.31 to 3.67 with HR+ as reference), but OS was significantly worse for TN patients than for HR+ patients (hazard ratio: 4.37; 95% confidence interval: 1.56 to 12.24). In HER2+ patients, the 5-year OS and RFS trended better for patients with ER+ or PR+ disease than for patients with ER-negative and PR-negative disease (5-year OS: 92.1% vs. 86.9%; 5-year RFS: 79.8% vs. 71.4%). Of HER2+ patients, just 80.9% received trastuzumab, including 33.3% of HER2+ patients with sub-centimetre tumours. Conclusions: In the trastuzumab era, patients with HER2+ and HR+ early breast cancer have similar outcomes, while TN patients experience a significantly worse OS than either of the foregoing groups. Outcomes for HER2+ patients may differ by ER and PR status. Trastuzumab was underutilized in this cohort.
Keywords: her2-positive breast cancer; survival; trastuzumab; adjuvant her2-positive breast cancer; survival; trastuzumab; adjuvant
MDPI and ACS Style

Zurawska, U.; Baribeau, D.A.; Giilck, S.; Victor, C.; Gandhi, S.; Florescu, A.; Verma, S. Outcomes of her2-positive Early-Stage Breast Cancer in the Trastuzumab Era: A Population-Based Study of Canadian Patients. Curr. Oncol. 2013, 20, 539-545. https://doi.org/10.3747/co.20.1523

AMA Style

Zurawska U, Baribeau DA, Giilck S, Victor C, Gandhi S, Florescu A, Verma S. Outcomes of her2-positive Early-Stage Breast Cancer in the Trastuzumab Era: A Population-Based Study of Canadian Patients. Current Oncology. 2013; 20(6):539-545. https://doi.org/10.3747/co.20.1523

Chicago/Turabian Style

Zurawska, U.; Baribeau, D.A.; Giilck, S.; Victor, C.; Gandhi, S.; Florescu, A.; Verma, S. 2013. "Outcomes of her2-positive Early-Stage Breast Cancer in the Trastuzumab Era: A Population-Based Study of Canadian Patients" Curr. Oncol. 20, no. 6: 539-545. https://doi.org/10.3747/co.20.1523

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