Yulou Luo, Yilina Saibaidula, Yutian Sun, Yinghui Ye, Jianghua Ou
{"title":"激素受体低阳性(1%-10%)乳腺癌患者的治疗和预后:回顾性倾向评分匹配分析","authors":"Yulou Luo, Yilina Saibaidula, Yutian Sun, Yinghui Ye, Jianghua Ou","doi":"10.1007/s12282-025-01730-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the clinicopathological characteristics, treatment patterns, and survival outcomes of hormone receptor (HR)-low positive (1%-10%) breast cancer, with a focus on evaluating the prognostic impact of endocrine therapy (ET) and its interplay with HR-low positive categories (ER-low/PR-low, ER-low/PR-negative, ER-negative/PR-low).</p><p><strong>Methods: </strong>A retrospective analysis of 16,578 patients with stage I-III breast cancer (July 2009 to December 2019) identified 388 HR-low positive cases. Propensity score match (PSM) was used to balance baseline characteristics in two comparisons: (1) HR-low positive patients receiving ET vs. HR-negative patients; (2) HR-low positive patients with vs. without ET. 5-year disease-free survival (DFS) and breast cancer-specific survival (BCSS) were analyzed via Kaplan-Meier and Cox regression analyses. Subgroup and interaction analyses assessed ET efficacy across HR-low positive categories.</p><p><strong>Results: </strong>HR-low positive tumors (2.34%) exhibited clinicopathological similarities to HR-negative tumors but distinct from HR-positive tumors. ET administration significantly improved DFS of HR-low positive patients compared to HR-negative counterparts (84.89% vs. 75.87%; HR = 0.59 [0.37-0.93], P = 0.024). Within HR-low positive cohort, ET omission was significantly associated with a 74% increased risk of DFS compared to ET-treated patients (75.54% vs. 85.37%; HR = 1.74 [1.01-3.00], P = 0.047). ET duration (1-4 vs. 5 years) did not affect survival outcomes (DFS: P = 0.533; BCSS: P = 0.675). Multivariate analysis confirmed ET omission as an independent risk factor for worse DFS (HR = 1.75 [1.01-3.05], P = 0.046). Subgroup analysis revealed equivalent ET benefit across all HR-low positive categories (P for interaction > 0.9).</p><p><strong>Conclusion: </strong>HR-low positive breast cancer has similar clinicopathological characteristics and therapeutic options with HR-negative disease but derives significant DFS benefits from ET, irrespective of ET duration or HR category. These findings support integrating ET into standard management protocol for HR-low positive breast cancer to ameliorate survival outcomes.</p>","PeriodicalId":520574,"journal":{"name":"Breast cancer (Tokyo, Japan)","volume":" ","pages":"1023-1034"},"PeriodicalIF":2.9000,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Treatment and prognosis of patients with hormone receptor-low positive (1%-10%) breast cancer: a retrospective propensity score-matched analysis.\",\"authors\":\"Yulou Luo, Yilina Saibaidula, Yutian Sun, Yinghui Ye, Jianghua Ou\",\"doi\":\"10.1007/s12282-025-01730-6\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to investigate the clinicopathological characteristics, treatment patterns, and survival outcomes of hormone receptor (HR)-low positive (1%-10%) breast cancer, with a focus on evaluating the prognostic impact of endocrine therapy (ET) and its interplay with HR-low positive categories (ER-low/PR-low, ER-low/PR-negative, ER-negative/PR-low).</p><p><strong>Methods: </strong>A retrospective analysis of 16,578 patients with stage I-III breast cancer (July 2009 to December 2019) identified 388 HR-low positive cases. Propensity score match (PSM) was used to balance baseline characteristics in two comparisons: (1) HR-low positive patients receiving ET vs. HR-negative patients; (2) HR-low positive patients with vs. without ET. 5-year disease-free survival (DFS) and breast cancer-specific survival (BCSS) were analyzed via Kaplan-Meier and Cox regression analyses. Subgroup and interaction analyses assessed ET efficacy across HR-low positive categories.</p><p><strong>Results: </strong>HR-low positive tumors (2.34%) exhibited clinicopathological similarities to HR-negative tumors but distinct from HR-positive tumors. ET administration significantly improved DFS of HR-low positive patients compared to HR-negative counterparts (84.89% vs. 75.87%; HR = 0.59 [0.37-0.93], P = 0.024). Within HR-low positive cohort, ET omission was significantly associated with a 74% increased risk of DFS compared to ET-treated patients (75.54% vs. 85.37%; HR = 1.74 [1.01-3.00], P = 0.047). ET duration (1-4 vs. 5 years) did not affect survival outcomes (DFS: P = 0.533; BCSS: P = 0.675). Multivariate analysis confirmed ET omission as an independent risk factor for worse DFS (HR = 1.75 [1.01-3.05], P = 0.046). Subgroup analysis revealed equivalent ET benefit across all HR-low positive categories (P for interaction > 0.9).</p><p><strong>Conclusion: </strong>HR-low positive breast cancer has similar clinicopathological characteristics and therapeutic options with HR-negative disease but derives significant DFS benefits from ET, irrespective of ET duration or HR category. 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引用次数: 0
摘要
目的:本研究旨在探讨激素受体(HR)低阳性(1%-10%)乳腺癌的临床病理特征、治疗模式和生存结局,重点评估内分泌治疗(ET)对预后的影响及其与HR低阳性类别(er低/ pr低、er低/ pr阴性、er阴性/ pr低)的相互作用。方法:回顾性分析16,578例I-III期乳腺癌患者(2009年7月至2019年12月),发现388例hr低阳性病例。倾向评分匹配(PSM)用于平衡两种比较的基线特征:(1)接受ET治疗的hr低阳性患者与hr阴性患者;(2)采用Kaplan-Meier和Cox回归分析,比较低hr阳性患者与未ET患者的5年无病生存率(DFS)和乳腺癌特异性生存率(BCSS)。亚组分析和相互作用分析评估了低hr阳性类别的ET疗效。结果:hr低阳性肿瘤(2.34%)临床病理与hr阴性肿瘤相似,但与hr阳性肿瘤不同。与hr阴性患者相比,给药ET显著改善hr低阳性患者的DFS (84.89% vs 75.87%;Hr = 0.59 [0.37-0.93], p = 0.024)。在hr低阳性队列中,与接受ET治疗的患者相比,ET遗漏与DFS风险增加74%显著相关(75.54% vs 85.37%;Hr = 1.74 [1.01-3.00], p = 0.047)。ET持续时间(1-4年vs. 5年)不影响生存结果(DFS: P = 0.533;Bcss: p = 0.675)。多因素分析证实ET遗漏是加重DFS的独立危险因素(HR = 1.75 [1.01-3.05], P = 0.046)。亚组分析显示,在所有低hr阳性类别中,ET的益处是相等的(相互作用的P值为0.9)。结论:低HR阳性乳腺癌与HR阴性疾病具有相似的临床病理特征和治疗选择,但无论ET持续时间或HR类别如何,ET均可获得显著的DFS益处。这些发现支持将ET纳入低hr阳性乳腺癌的标准管理方案,以改善生存结果。
Treatment and prognosis of patients with hormone receptor-low positive (1%-10%) breast cancer: a retrospective propensity score-matched analysis.
Objective: This study aimed to investigate the clinicopathological characteristics, treatment patterns, and survival outcomes of hormone receptor (HR)-low positive (1%-10%) breast cancer, with a focus on evaluating the prognostic impact of endocrine therapy (ET) and its interplay with HR-low positive categories (ER-low/PR-low, ER-low/PR-negative, ER-negative/PR-low).
Methods: A retrospective analysis of 16,578 patients with stage I-III breast cancer (July 2009 to December 2019) identified 388 HR-low positive cases. Propensity score match (PSM) was used to balance baseline characteristics in two comparisons: (1) HR-low positive patients receiving ET vs. HR-negative patients; (2) HR-low positive patients with vs. without ET. 5-year disease-free survival (DFS) and breast cancer-specific survival (BCSS) were analyzed via Kaplan-Meier and Cox regression analyses. Subgroup and interaction analyses assessed ET efficacy across HR-low positive categories.
Results: HR-low positive tumors (2.34%) exhibited clinicopathological similarities to HR-negative tumors but distinct from HR-positive tumors. ET administration significantly improved DFS of HR-low positive patients compared to HR-negative counterparts (84.89% vs. 75.87%; HR = 0.59 [0.37-0.93], P = 0.024). Within HR-low positive cohort, ET omission was significantly associated with a 74% increased risk of DFS compared to ET-treated patients (75.54% vs. 85.37%; HR = 1.74 [1.01-3.00], P = 0.047). ET duration (1-4 vs. 5 years) did not affect survival outcomes (DFS: P = 0.533; BCSS: P = 0.675). Multivariate analysis confirmed ET omission as an independent risk factor for worse DFS (HR = 1.75 [1.01-3.05], P = 0.046). Subgroup analysis revealed equivalent ET benefit across all HR-low positive categories (P for interaction > 0.9).
Conclusion: HR-low positive breast cancer has similar clinicopathological characteristics and therapeutic options with HR-negative disease but derives significant DFS benefits from ET, irrespective of ET duration or HR category. These findings support integrating ET into standard management protocol for HR-low positive breast cancer to ameliorate survival outcomes.