Personalizing extent of breast cancer surgery according to molecular subtypes

Breast. 2013 Aug:22 Suppl 2:S106-9. doi: 10.1016/j.breast.2013.07.020.

Abstract

The molecular subtype of breast cancer is the major determinant of the type of systemic therapy, but less attention has been paid to the impact of subtype on local therapy outcomes. Presenting features of breast cancer vary with hormone receptor status, with triple negative cancers being significantly less likely than hormone receptor positive cancers to have nodal metastases, and HER2 overexpressing cancers being more likely to be multifocal or multicentric and to have an extensive intraductal component. The risk of local recurrence varies with subtype as well, with triple negative cancers having the highest risk of local recurrence after both breast-conserving therapy and mastectomy, indicating that bigger surgery does not overcome bad biology.

Keywords: Local recurrence; Local therapy; Molecular subtype.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / pathology
  • Breast Neoplasms / surgery*
  • Female
  • Follow-Up Studies
  • Gene Expression Regulation, Neoplastic
  • Genetic Testing
  • Humans
  • Lymph Nodes / pathology
  • Mastectomy / methods*
  • Mastectomy / mortality
  • Mastectomy, Segmental / methods
  • Mastectomy, Segmental / mortality
  • Middle Aged
  • Molecular Biology
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Recurrence, Local / prevention & control
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Staging
  • Precision Medicine / methods*
  • Preoperative Care / methods
  • Receptor, ErbB-2 / genetics
  • Receptor, ErbB-2 / metabolism
  • Receptors, Estrogen / genetics
  • Receptors, Estrogen / metabolism
  • Risk Assessment
  • Survival Analysis
  • Treatment Outcome

Substances

  • Receptors, Estrogen
  • Receptor, ErbB-2