Progesterone receptor status and Ki-67 index may predict early relapse in luminal B/HER2 negative breast cancer patients: a retrospective study

Yu Zong; Li Zhu; Jiayi Wu; Xiaosong Chen; Ou Huang; Xiaochun Fei; Jianrong He; Weiguo Chen; Yafen Li; Kunwei Shen

doi:10.1371/journal.pone.0095629

Progesterone receptor status and Ki-67 index may predict early relapse in luminal B/HER2 negative breast cancer patients: a retrospective study

PLoS One. 2014 Aug 29;9(8):e95629. doi: 10.1371/journal.pone.0095629. eCollection 2014.

Authors

Yu Zong¹, Li Zhu¹, Jiayi Wu¹, Xiaosong Chen¹, Ou Huang¹, Xiaochun Fei², Jianrong He¹, Weiguo Chen¹, Yafen Li¹, Kunwei Shen¹

Affiliations

¹ Comprehensive Breast Health Center, Shanghai Ruijin Hospital affiliated to Medical School of Shanghai Jiaotong University, Shanghai, China.
² Pathology Department, Shanghai Ruijin Hospital affiliated to Medical School of Shanghai Jiaotong University, Shanghai, China.

Abstract

Purpose: Few studies has documented early relapse in luminal B/HER2-negative breast cancer. We examined prognostic factors for early relapse among these patients to improve treatment decision-making.

Patients and methods: A total 398 patients with luminal B/HER2-negative breast cancer were included. Kaplan-Meier curves were applied to estimate disease-free survival and Cox regression to identify prognostic factors.

Results: Progesterone receptor (PR) negative expression was associated with higher tumor grade (p<.001) and higher Ki-67 index (p = .010). PR-negative patients received more chemotherapy than the PR-positive group (p = .009). After a median follow-up of 28 months, 17 patients (4.3%) had early relapses and 8 patients (2.0%) died of breast cancer. The 2-year disease-free survival was 97.7% in the PR-positive and 90.4% in the PR-negative groups (Log-rank p = .002). Also, patients with a high Ki-67 index (defined as >30%) had a reduced disease-free survival (DFS) when compared with low Ki-67 index group (≤30%) (98.0% vs 92.4%, respectively, Log-rank p = .013). In multivariate analysis, PR negativity was significantly associated with a reduced DFS (HR = 3.91, 95% CI 1.29-11.88, p = .016).

Conclusion: In this study, PR negativity was a prognostic factor for early relapse in luminal B/HER2-negative breast cancer, while a high Ki-67 index suggested a higher risk of early relapse.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Breast Neoplasms / metabolism*
Breast Neoplasms / mortality*
Breast Neoplasms / pathology
Disease-Free Survival
Female
Gene Expression Regulation, Neoplastic*
Humans
Ki-67 Antigen / biosynthesis*
Middle Aged
Receptor, ErbB-2*
Receptors, Progesterone / biosynthesis*
Recurrence
Retrospective Studies
Survival Rate

Substances

Ki-67 Antigen
Receptors, Progesterone
ERBB2 protein, human
Receptor, ErbB-2

Grants and funding

This study was supported by Shanghai Natural Science Foundation 11ZR1422900, National Natural Science Foundation of China (Young Investigators) 81102017 and Wu Jieping Medical Foundation 320.6750.12285. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.