Breast Cancer Subtypes and Locoregional Recurrence: Tailoring Surveillance to Improve Patient Outcomes

By: Amanda E. Ruffino, BA
Posted: Friday, September 29, 2023

Jong-Ho Cheun, MD, MS, of Seoul National University Boramae Medical Center, South Korea, and colleagues aimed to explore the locoregional recurrence patterns in patients with breast cancer with different molecular subtypes and the clinical implications of these subtypes. Their findings, published in JAMA Surgery, showed that locoregional recurrence occurred based on breast cancer subtype, with younger patients having greater differences in patterns among subtypes than older patients.

“The findings suggest that tailoring surveillance should be recommended regarding differences in locoregional recurrence patterns according to tumor subtypes, particularly for younger patients,” the investigators concluded.

The study authors retrospectively analyzed clinical records from 16,462 female patients with breast cancer who underwent surgery at a single institution in South Korea between January 2000 and December 2018. The median age at the time of surgery was 49 years. The 10-year survival rates for ipsilateral breast tumor recurrence, regional recurrence, and contralateral breast cancer were 95.9%, 96.1%, and 96.5%, respectively.

The findings revealed significant differences in recurrence patterns among molecular subtypes. Patients with hormone receptor (HR)-negative, ERBB2-positive tumors had the worst ipsilateral breast tumor recurrence–free survival rates, and those with HR-negative/ERBB2-negative subtype tumors had the worst regional recurrence and contralateral breast cancer–free survival rates.

Annual recurrence patterns also varied based on subtypes. HR-negative, ERBB2-positive and HR-negative, ERBB2-negative subtypes exhibited double peaks in ipsilateral breast tumor recurrence, whereas HR-positive, ERBB2-negative tumors showed a steadily increasing pattern without distinct peaks. Regional recurrence incidence rates were highest at 1 year after surgery for most subtypes, gradually decreasing thereafter. Contralateral breast cancer incidence steadily increased for all subtypes, with the HR-negative, ERBB2-negative subtype linked to the highest incidence over 10 years. Of note, younger patients (≤ 40 years) showed more significant differences in ipsilateral breast tumor recurrence, regional recurrence, and contralateral breast cancer patterns among subtypes compared with older patients.

Disclosure: For full disclosures of the study authors, visit jamanetwork.com.

JAMA Surgery

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