Tamoxifen therapy improves overall survival in luminal A subtype of ductal carcinoma in situ: a study based on nationwide Korean Breast Cancer Registry database

Korean Breast Cancer Society

doi:10.1007/s10549-018-4681-6

Tamoxifen therapy improves overall survival in luminal A subtype of ductal carcinoma in situ: a study based on nationwide Korean Breast Cancer Registry database

Korean Breast Cancer Society

Department of Surgery

Research output: Contribution to journal › Article › peer-review

12 Citations (Scopus)

Abstract

Purpose: To determine the prognostic role of tamoxifen therapy for patients with ductal carcinoma in situ (DCIS) according to molecular subtypes. Methods: Data of 14,944 patients with DCIS were analyzed. Molecular subtypes were classified into four categories based on expression of estrogen receptor (ER)/progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). Kaplan–Meier estimator was used for overall survival analysis while Cox proportional hazards model was used for univariate and multivariate analyses. Results: Luminal A subtype (ER/PR+, HER2−) showed higher (P = .009) survival rate than triple-negative (TN) subtype. Tamoxifen therapy group showed superior (P < .001) survival than no-tamoxifen therapy group. It had survival benefit only for luminal A subtype (P = .001). Tamoxifen therapy resulted in higher survival rate in subgroups with positive ER (P = .006), positive PR (P = .009), and negative HER2 (P < .001). In luminal A subtype, tamoxifen therapy showed lower hazard ratio (HR) compared to no-tamoxifen therapy (HR, 0.420; 95% CI 0.250–0.705; P = .001). Tamoxifen therapy was a significant independent factor by multivariate analysis (HR, 0.538; 95% CI 0.306–0.946; P = .031) as well as univariate analysis. Conclusion: Tamoxifen therapy group showed superior prognosis than the no-tamoxifen therapy group. Its prognostic influence was only effective for luminal A subtype. Patients with luminal A subtype showed higher survival rate than those with TN subtype. Active tamoxifen therapy is recommended for DCIS patients with luminal A subtype, and routine tests for ER, PR, and HER2 should be considered for DCIS.

Original language	English
Pages (from-to)	311-322
Number of pages	12
Journal	Breast Cancer Research and Treatment
Volume	169
Issue number	2
DOIs	https://doi.org/10.1007/s10549-018-4681-6
Publication status	Published - 2018 Jun 1

Bibliographical note

Funding Information:
Acknowledgements This article was supported by the Korean Breast Cancer Society (WA35-20170205-01). Grant sponsor The research for this manuscript was not financially supported and none of the authors had any relevant financial relationships. We appreciate valuable discussion from the members of the Boramae hospital Breast cancer Study group (BBS).

Publisher Copyright:
© 2018, Springer Science+Business Media, LLC, part of Springer Nature.

All Science Journal Classification (ASJC) codes

Oncology
Cancer Research

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1007/s10549-018-4681-6

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@article{1ffc4abdd3ee42ce925f3617619dbe5c,

title = "Tamoxifen therapy improves overall survival in luminal A subtype of ductal carcinoma in situ: a study based on nationwide Korean Breast Cancer Registry database",

abstract = "Purpose: To determine the prognostic role of tamoxifen therapy for patients with ductal carcinoma in situ (DCIS) according to molecular subtypes. Methods: Data of 14,944 patients with DCIS were analyzed. Molecular subtypes were classified into four categories based on expression of estrogen receptor (ER)/progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). Kaplan–Meier estimator was used for overall survival analysis while Cox proportional hazards model was used for univariate and multivariate analyses. Results: Luminal A subtype (ER/PR+, HER2−) showed higher (P = .009) survival rate than triple-negative (TN) subtype. Tamoxifen therapy group showed superior (P < .001) survival than no-tamoxifen therapy group. It had survival benefit only for luminal A subtype (P = .001). Tamoxifen therapy resulted in higher survival rate in subgroups with positive ER (P = .006), positive PR (P = .009), and negative HER2 (P < .001). In luminal A subtype, tamoxifen therapy showed lower hazard ratio (HR) compared to no-tamoxifen therapy (HR, 0.420; 95% CI 0.250–0.705; P = .001). Tamoxifen therapy was a significant independent factor by multivariate analysis (HR, 0.538; 95% CI 0.306–0.946; P = .031) as well as univariate analysis. Conclusion: Tamoxifen therapy group showed superior prognosis than the no-tamoxifen therapy group. Its prognostic influence was only effective for luminal A subtype. Patients with luminal A subtype showed higher survival rate than those with TN subtype. Active tamoxifen therapy is recommended for DCIS patients with luminal A subtype, and routine tests for ER, PR, and HER2 should be considered for DCIS.",

author = "{Korean Breast Cancer Society} and Hwang, {Ki Tae} and Kim, {Eun Kyu} and Jung, {Sung Hoo} and Lee, {Eun Sook} and Kim, {Seung Il} and Seokwon Lee and Park, {Heung Kyu} and Jongjin Kim and Sohee Oh and Kim, {Young A.} and Ahn, {Sei Hyun} and Noh, {Dong Young} and Nam, {Seok Jin} and Lee, {Eun Sook} and Park, {Byeong Woo} and Noh, {Woo Chul} and Yoon, {Jung Han} and Lee, {Soo Jung} and Lee, {Eun Kyu} and Joon Jeong and Sehwan Han and Park, {Ho Yong} and Paik, {Nam Sun} and Bae, {Young Tae} and Lee, {Hyouk Jin} and Park, {Heung kyu} and Ko, {Seung Sang} and Song, {Byung Joo} and Suh, {Young Jin} and Jung, {Sung Hoo} and Cho, {Se Heon} and Kim, {Sei Joong} and Oh, {Se Jeong} and Ko, {Byung Kyun} and Kim, {Ku Sang} and Chanheun Park and Baek, {Jong Min} and Hwang, {Ki Tae} and Chang, {Il Sung} and Bae, {Jeoung Won} and Kim, {Jeong Soo} and Kang, {Sun Hee} and Geumhee Gwak and Lee, {Jee Hyun} and Kim, {Tae Hyun} and Myungchul Chang and Kim, {Sung Yong} and Lee, {Jung Sun} and Song, {Jeong Yoon} and Park, {Hai Lin}",

note = "Funding Information: Acknowledgements This article was supported by the Korean Breast Cancer Society (WA35-20170205-01). Grant sponsor The research for this manuscript was not financially supported and none of the authors had any relevant financial relationships. We appreciate valuable discussion from the members of the Boramae hospital Breast cancer Study group (BBS). Publisher Copyright: {\textcopyright} 2018, Springer Science+Business Media, LLC, part of Springer Nature.",

year = "2018",

month = jun,

day = "1",

doi = "10.1007/s10549-018-4681-6",

language = "English",

volume = "169",

pages = "311--322",

journal = "Breast Cancer Research and Treatment",

issn = "0167-6806",

publisher = "Springer New York",

number = "2",

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TY - JOUR

T1 - Tamoxifen therapy improves overall survival in luminal A subtype of ductal carcinoma in situ

T2 - a study based on nationwide Korean Breast Cancer Registry database

AU - Korean Breast Cancer Society

AU - Hwang, Ki Tae

AU - Kim, Eun Kyu

AU - Jung, Sung Hoo

AU - Lee, Eun Sook

AU - Kim, Seung Il

AU - Lee, Seokwon

AU - Park, Heung Kyu

AU - Kim, Jongjin

AU - Oh, Sohee

AU - Kim, Young A.

AU - Ahn, Sei Hyun

AU - Noh, Dong Young

AU - Nam, Seok Jin

AU - Lee, Eun Sook

AU - Park, Byeong Woo

AU - Noh, Woo Chul

AU - Yoon, Jung Han

AU - Lee, Soo Jung

AU - Lee, Eun Kyu

AU - Jeong, Joon

AU - Han, Sehwan

AU - Park, Ho Yong

AU - Paik, Nam Sun

AU - Bae, Young Tae

AU - Lee, Hyouk Jin

AU - Park, Heung kyu

AU - Ko, Seung Sang

AU - Song, Byung Joo

AU - Suh, Young Jin

AU - Jung, Sung Hoo

AU - Cho, Se Heon

AU - Kim, Sei Joong

AU - Oh, Se Jeong

AU - Ko, Byung Kyun

AU - Kim, Ku Sang

AU - Park, Chanheun

AU - Baek, Jong Min

AU - Hwang, Ki Tae

AU - Chang, Il Sung

AU - Bae, Jeoung Won

AU - Kim, Jeong Soo

AU - Kang, Sun Hee

AU - Gwak, Geumhee

AU - Lee, Jee Hyun

AU - Kim, Tae Hyun

AU - Chang, Myungchul

AU - Kim, Sung Yong

AU - Lee, Jung Sun

AU - Song, Jeong Yoon

AU - Park, Hai Lin

N1 - Funding Information: Acknowledgements This article was supported by the Korean Breast Cancer Society (WA35-20170205-01). Grant sponsor The research for this manuscript was not financially supported and none of the authors had any relevant financial relationships. We appreciate valuable discussion from the members of the Boramae hospital Breast cancer Study group (BBS). Publisher Copyright: © 2018, Springer Science+Business Media, LLC, part of Springer Nature.

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Purpose: To determine the prognostic role of tamoxifen therapy for patients with ductal carcinoma in situ (DCIS) according to molecular subtypes. Methods: Data of 14,944 patients with DCIS were analyzed. Molecular subtypes were classified into four categories based on expression of estrogen receptor (ER)/progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). Kaplan–Meier estimator was used for overall survival analysis while Cox proportional hazards model was used for univariate and multivariate analyses. Results: Luminal A subtype (ER/PR+, HER2−) showed higher (P = .009) survival rate than triple-negative (TN) subtype. Tamoxifen therapy group showed superior (P < .001) survival than no-tamoxifen therapy group. It had survival benefit only for luminal A subtype (P = .001). Tamoxifen therapy resulted in higher survival rate in subgroups with positive ER (P = .006), positive PR (P = .009), and negative HER2 (P < .001). In luminal A subtype, tamoxifen therapy showed lower hazard ratio (HR) compared to no-tamoxifen therapy (HR, 0.420; 95% CI 0.250–0.705; P = .001). Tamoxifen therapy was a significant independent factor by multivariate analysis (HR, 0.538; 95% CI 0.306–0.946; P = .031) as well as univariate analysis. Conclusion: Tamoxifen therapy group showed superior prognosis than the no-tamoxifen therapy group. Its prognostic influence was only effective for luminal A subtype. Patients with luminal A subtype showed higher survival rate than those with TN subtype. Active tamoxifen therapy is recommended for DCIS patients with luminal A subtype, and routine tests for ER, PR, and HER2 should be considered for DCIS.

AB - Purpose: To determine the prognostic role of tamoxifen therapy for patients with ductal carcinoma in situ (DCIS) according to molecular subtypes. Methods: Data of 14,944 patients with DCIS were analyzed. Molecular subtypes were classified into four categories based on expression of estrogen receptor (ER)/progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). Kaplan–Meier estimator was used for overall survival analysis while Cox proportional hazards model was used for univariate and multivariate analyses. Results: Luminal A subtype (ER/PR+, HER2−) showed higher (P = .009) survival rate than triple-negative (TN) subtype. Tamoxifen therapy group showed superior (P < .001) survival than no-tamoxifen therapy group. It had survival benefit only for luminal A subtype (P = .001). Tamoxifen therapy resulted in higher survival rate in subgroups with positive ER (P = .006), positive PR (P = .009), and negative HER2 (P < .001). In luminal A subtype, tamoxifen therapy showed lower hazard ratio (HR) compared to no-tamoxifen therapy (HR, 0.420; 95% CI 0.250–0.705; P = .001). Tamoxifen therapy was a significant independent factor by multivariate analysis (HR, 0.538; 95% CI 0.306–0.946; P = .031) as well as univariate analysis. Conclusion: Tamoxifen therapy group showed superior prognosis than the no-tamoxifen therapy group. Its prognostic influence was only effective for luminal A subtype. Patients with luminal A subtype showed higher survival rate than those with TN subtype. Active tamoxifen therapy is recommended for DCIS patients with luminal A subtype, and routine tests for ER, PR, and HER2 should be considered for DCIS.

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U2 - 10.1007/s10549-018-4681-6

DO - 10.1007/s10549-018-4681-6

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SN - 0167-6806

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SP - 311

EP - 322

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

IS - 2

ER -

Tamoxifen therapy improves overall survival in luminal A subtype of ductal carcinoma in situ: a study based on nationwide Korean Breast Cancer Registry database

Abstract

Bibliographical note

All Science Journal Classification (ASJC) codes

UN SDGs

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