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Pathology parameters and adjuvant tamoxifen response in a randomised premenopausal breast cancer trial.

Abstract：

BACKGROUND:Subgroups of breast cancer that have an impaired response to endocrine treatment, despite hormone receptor positivity, are still poorly defined. Breast cancer can be subdivided according to standard pathological parameters including histological type, grade, and assessment of proliferation. These parameters are the net result of combinations of genetic alterations effecting tumour behaviour and could potentially reflect subtypes that respond differently to endocrine treatment. AIMS:To investigate the usefulness of these parameters as predictors of the response to tamoxifen in premenopausal women with breast cancer. MATERIALS/METHODS:Clinically established pathological parameters were assessed and related to the tamoxifen response in 500 available tumour specimens from 564 premenopausal patients with breast cancer randomised to either two years of tamoxifen or no treatment with 14 years of follow up. Proliferation was further evaluated by immunohistochemical Ki-67 expression. RESULTS:Oestrogen receptor positive ductal carcinomas responded as expected to tamoxifen, whereas the difference in recurrence free survival between control and tamoxifen treated patients was less apparent in the relatively few lobular carcinomas. For histological grade, there was no obvious difference in treatment response between the groups. The relation between proliferation and tamoxifen response seemed to be more complex, with a clear response in tumours with high and low proliferation, whereas tumours with intermediate proliferation defined by Ki-67 responded more poorly. CONCLUSIONS:Clinically established pathology parameters seem to mirror the endocrine treatment response and could potentially be valuable in future treatment decisions for patients with breast cancer.

journal_name

J Clin Pathol

journal_title

Journal of clinical pathology

authors

Jirström K,Rydén L,Anagnostaki L,Nordenskjöld B,Stål O,Thorstenson S,Chebil G,Jönsson PE,Fernö M,Landberg G

doi

10.1136/jcp.2005.027185

keywords:

subject

Has Abstract

pub_date

2005-11-01 00:00:00

pages

1135-42

issue

eissn

0021-9746

issn

1472-4146

pii

58/11/1135

journal_volume

pub_type

杂志文章,多中心研究,随机对照试验

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Pathology parameters and adjuvant tamoxifen response in a randomised premenopausal breast cancer trial.