Journal Article
. 2014 Mar; 50(8):1412-21.
doi: 10.1016/j.ejca.2014.02.022.

Estrogen receptor, Progesterone receptor, HER2 status and Ki67 index and responsiveness to adjuvant tamoxifen in postmenopausal high-risk breast cancer patients enrolled in the DBCG 77C trial

Ann S Knoop 1 Anne-Vibeke Lænkholm 2 Maj-Britt Jensen 3 Kirsten V Nielsen 4 Jørn Andersen 5 Dorte Nielsen 6 Bent Ejlertsen 7 Danish Breast Cancer Cooperative Group  
Affiliations
  • PMID: 24675287
  •     7 citations

Abstract

Background: The DBCG 77C trial compared one year of tamoxifen in postmenopausal, steroid-receptor unknown, high-risk breast cancer patients to no adjuvant systemic therapy. After a potential follow-up of 30years we report overall efficacy of the study and results according to subtypes subsequently assessed by immunohistochemistry and fluorescent in situ hybridisation (FISH).

Methods: Between 1977 and 1982, 1716 postmenopausal patients with tumours larger than 5cm or positive axillary nodes were randomly assigned to no systemic therapy or tamoxifen 30mg daily for one year. Archival tumour tissue from 1515 patients was analysed and the hormone receptor positive (estrogen receptor (ER) and/or progesterone receptor (PR)) cancers were defined as luminal A if Ki67 low and HER2-negative; as luminal B if Ki67 high or HER2-positive; and otherwise as non-luminal-HER2 positive or triple negative.

Findings: In the intent-to-treat (ITT) population one year of tamoxifen improved the disease-free-survival (DFS) (hazard ratio (HR)=0.87; 95% confidence interval (CI) 0.77-0.98), the Breast Cancer Recurrence Rate (BCRR) (HR=0.79; 0.69-0.90) and reduced the breast-cancer-specific-mortality (BCM) (HR=0.83; 0.73-0.93). BCRR were improved significantly by tamoxifen in luminal A (HR=0.66; 0.53-0.84) and luminal B/HER2- (HR=0.54; 0.39-0.74) but not in the other subsets, and with similar results for BCM with 30years follow-up.

Interpretation: One year of treatment with tamoxifen significantly improves BCRR and BCM in postmenopausal patients with ER positive breast cancers. The relative benefit from tamoxifen was not significantly different in luminal A and B subtypes.

Funding: The Danish Breast Cancer Cooperative Group (DBCG) prepared the original protocol (DBCG 77C) and was the sponsor of the study. Funding was not provided to the participating departments. The biomarker study was supported by grants from the Clinical Institute, Odense University.

Keywords: Breast; Menopausal; Randomised adjuvant phase III trial; Subtypes; Tamoxifen.

MicroRNAs expression in triple negative vs non triple negative breast cancer in Tunisia: interaction with clinical outcome.
Imen Medimegh, Ines Omrane, +8 authors, Amel Benammar Elgaaied.
PLoS One, 2014 Nov 05; 9(11). PMID: 25369070    Free PMC article.
Phosphorylation of androgen receptors at serine 515 is a potential prognostic marker for triple negative breast cancer.
Antonia K Roseweir, Pamela McCall, +4 authors, Joanne Edwards.
Oncotarget, 2017 Apr 19; 8(23). PMID: 28415597    Free PMC article.
ERα and ERβ co-expression: An indicator of aggressive tumors and hormonal sensitivity.
Mohamed Oueslati, Ilhem Bittaieb, +4 authors, Ridha Oueslati.
Oncol Lett, 2017 Aug 16; 14(2). PMID: 28808484    Free PMC article.
miR-221 stimulates breast cancer cells and cancer-associated fibroblasts (CAFs) through selective interference with the A20/c-Rel/CTGF signaling.
Maria Francesca Santolla, Rosamaria Lappano, +8 authors, Adele Vivacqua.
J Exp Clin Cancer Res, 2018 May 03; 37(1). PMID: 29716623    Free PMC article.
Omission of postoperative radiation after breast conserving surgery: A progressive paradigm shift towards precision medicine.
Pierfrancesco Franco, Fiorenza De Rose, +5 authors, Clinical Oncology Breast Cancer Group (COBCG) Investigators.
Clin Transl Radiat Oncol, 2020 Feb 25; 21. PMID: 32090175    Free PMC article.
Review.
Hormone Receptor Expression in Multicentric/Multifocal versus Unifocal Breast Cancer: Especially the VDR Determines the Outcome Related to Focality.
Alaleh Zati Zehni, Sven-Niclas Jacob, +5 authors, Theresa Vilsmaier.
Int J Mol Sci, 2019 Nov 17; 20(22). PMID: 31731733    Free PMC article.
Risk of recurrence among patients with HR-positive, HER2-negative, early breast cancer receiving adjuvant endocrine therapy: A systematic review and meta-analysis.
Elizabeth M Salvo, Abril Oliva Ramirez, +4 authors, Imtiaz A Samjoo.
Breast, 2021 Mar 08; 57. PMID: 33677313    Free PMC article.