Basal-like breast cancer defined by five biomarkers has superior prognostic value than triple-negative phenotype. Export

@article{citeulike:3088511, abstract = {PURPOSE: Basal-like breast cancer is associated with high grade, poor prognosis, and younger patient age. Clinically, a triple-negative phenotype definition [estrogen receptor, progesterone receptor, and human epidermal growth factor receptor (HER)-2, all negative] is commonly used to identify such cases. EGFR and cytokeratin 5/6 are readily available positive markers of basal-like breast cancer applicable to standard pathology specimens. This study directly compares the prognostic significance between three- and five-biomarker surrogate panels to define intrinsic breast cancer subtypes, using a large clinically annotated series of breast tumors. EXPERIMENTAL DESIGN: Four thousand forty-six invasive breast cancers were assembled into tissue microarrays. All had staging, pathology, treatment, and outcome information; median follow-up was 12.5 years. Cox regression analyses and likelihood ratio tests compared the prognostic significance for breast cancer death-specific survival (BCSS) of the two immunohistochemical panels. RESULTS: Among 3,744 interpretable cases, 17\% were basal using the triple-negative definition (10-year BCSS, 6 7\%) and 9\% were basal using the five-marker method (10-year BCSS, 62\%). Likelihood ratio tests of multivariable Cox models including standard clinical variables show that the five-marker panel is significantly more prognostic than the three-marker panel. The poor prognosis of triple-negative phenotype is conferred almost entirely by those tumors positive for basal markers. Among triple-negative patients treated with adjuvant anthracycline-based chemotherapy, the additional positive basal markers identified a cohort of patients with significantly worse outcome. CONCLUSIONS: The expanded surrogate immunopanel of estrogen receptor, progesterone receptor, human HER-2, EGFR, and cytokeratin 5/6 provides a more specific definition of basal-like breast cancer that better predicts breast cancer survival.}, address = {Genetic Pathology Evaluation Centre, Vancouver Coastal Health Research Institute, British Columbia Cancer Agency, and University of British Columbia, Vancouver, British Columbia, Canada.}, author = {Cheang, Maggie C. and Voduc, David and Bajdik, Chris and Leung, Samuel and McKinney, Steven and Chia, Stephen K. and Perou, Charles M. and Nielsen, Torsten O.}, citeulike-article-id = {3088511}, citeulike-linkout-0 = {http://dx.doi.org/10.1158/1078-0432.CCR-07-1658}, citeulike-linkout-1 = {http://view.ncbi.nlm.nih.gov/pubmed/18316557}, citeulike-linkout-2 = {http://www.hubmed.org/display.cgi?uids=18316557}, day = {1}, doi = {10.1158/1078-0432.CCR-07-1658}, issn = {1078-0432}, journal = {Clinical cancer research : an official journal of the American Association for Cancer Research}, keywords = {basal-like, biomarker, breast, her2, hr, subtypes, triple-negative}, month = {March}, number = {5}, pages = {1368--1376}, posted-at = {2009-11-10 05:42:06}, priority = {2}, title = {Basal-like breast cancer defined by five biomarkers has superior prognostic value than triple-negative phenotype.}, url = {http://dx.doi.org/10.1158/1078-0432.CCR-07-1658}, volume = {14}, year = {2008} }

TY - JOUR ID - citeulike:3088511 L3 - citeulike-article-id:3088511 N2 - PURPOSE: Basal-like breast cancer is associated with high grade, poor prognosis, and younger patient age. Clinically, a triple-negative phenotype definition [estrogen receptor, progesterone receptor, and human epidermal growth factor receptor (HER)-2, all negative] is commonly used to identify such cases. EGFR and cytokeratin 5/6 are readily available positive markers of basal-like breast cancer applicable to standard pathology specimens. This study directly compares the prognostic significance between three- and five-biomarker surrogate panels to define intrinsic breast cancer subtypes, using a large clinically annotated series of breast tumors. EXPERIMENTAL DESIGN: Four thousand forty-six invasive breast cancers were assembled into tissue microarrays. All had staging, pathology, treatment, and outcome information; median follow-up was 12.5 years. Cox regression analyses and likelihood ratio tests compared the prognostic significance for breast cancer death-specific survival (BCSS) of the two immunohistochemical panels. RESULTS: Among 3,744 interpretable cases, 17% were basal using the triple-negative definition (10-year BCSS, 6 7%) and 9% were basal using the five-marker method (10-year BCSS, 62%). Likelihood ratio tests of multivariable Cox models including standard clinical variables show that the five-marker panel is significantly more prognostic than the three-marker panel. The poor prognosis of triple-negative phenotype is conferred almost entirely by those tumors positive for basal markers. Among triple-negative patients treated with adjuvant anthracycline-based chemotherapy, the additional positive basal markers identified a cohort of patients with significantly worse outcome. CONCLUSIONS: The expanded surrogate immunopanel of estrogen receptor, progesterone receptor, human HER-2, EGFR, and cytokeratin 5/6 provides a more specific definition of basal-like breast cancer that better predicts breast cancer survival. IS - 5 JF - Clinical cancer research : an official journal of the American Association for Cancer Research SN - 1078-0432 AD - Genetic Pathology Evaluation Centre, Vancouver Coastal Health Research Institute, British Columbia Cancer Agency, and University of British Columbia, Vancouver, British Columbia, Canada. EP - 1376 TI - Basal-like breast cancer defined by five biomarkers has superior prognostic value than triple-negative phenotype. VL - 14 SP - 1368 KW - basal-like KW - biomarker KW - breast KW - her2 KW - hr KW - subtypes KW - triple-negative AU - Cheang, Maggie AU - Voduc, David AU - Bajdik, Chris AU - Leung, Samuel AU - McKinney, Steven AU - Chia, Stephen AU - Perou, Charles AU - Nielsen, Torsten PY - 2008/03/01/ UR - http://dx.doi.org/10.1158/1078-0432.CCR-07-1658 ER -