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Frank S, Carton M, Dubot C, Campone M, Pistilli B, Dalenc F, Mailliez A, Levy C, D'Hondt V, Debled M, Vermeulin T, Coudert B, Perrin C, Gonçalves A, Uwer L, Ferrero JM, Eymard JC, Petit T, Mouret-Reynier MA, Patsouris A, Guesmia T, Bachelot T, Robain M, Cottu P. Impact of age at diagnosis of metastatic breast cancer on overall survival in the real-life ESME metastatic breast cancer cohort. Breast 2020; 52:50-57. [PMID: 32380440 PMCID: PMC7375638 DOI: 10.1016/j.breast.2020.04.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 04/17/2020] [Accepted: 04/21/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Young age is a poor prognostic factor in early stage breast cancer (BC) but its value is less established in metastatic BC (MBC). We evaluated the impact of age at MBC diagnosis on overall survival (OS) across three age groups (<40, 40 to 60 and > 60 years(y)). METHODS ESME MBC database is a national cohort, collecting retrospective data from 18 participating French cancer centers between January 01, 2008 and December 31, 2014. RESULTS Among 14 403 women included, 1077 (7.5%), 6436 (44.7%) and 6890 (47.8%) pts were <40, 40-60 and > 60 y respectively. Pts <40 had significantly more aggressive presentations than other age groups: more frequent HER2+ (25.7 vs 15.3% in >60y) and triple negative subtypes (27.4 vs 14.6% in >60y), and more frequent visceral involvement (36.3 vs 29.8% in >60y). At a median follow-up of 48 months, median OS differed across age groups: 38.8, 38.4 and 35.6 months for pts <40, 40-60 and > 60y, respectively (p < 0.0001). Compared to pts <40y, older pts had a statistically significant higher risk of death (all causes of death included), although of limited clinical value (HR = 1.1, IC 95%:1.01-1.20). There was a significant trend for better OS in pts <40y with HER2+ and luminal diseases. A possible explanation is a greater use of anti-Her2 therapies as first-line treatments: 86.6, 81.9 and 74.9% for pts <40, 40-60 and > 60y, respectively (p < 0.0001). CONCLUSION Although young age seems associated with more aggressive presentations at diagnosis of MBC, it has no deleterious effect on OS in this large series.
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Affiliation(s)
- Sophie Frank
- Institut Curie, Paris-Saint Cloud, 26, Rue d'Ulm, 75005, Paris, France.
| | - Matthieu Carton
- Institut Curie, Paris-Saint Cloud, 26, Rue d'Ulm, 75005, Paris, France.
| | - Coraline Dubot
- Institut Curie, Paris-Saint Cloud, 26, Rue d'Ulm, 75005, Paris, France.
| | - Mario Campone
- Institut de Cancérologie de l'Ouest, site René Gauducheau, Site Hospitalier Nord, Boulevard Jacques Monod, 44800, Saint-Herblain, France.
| | - Barbara Pistilli
- Gustave Roussy, 39, Rue Camille Desmoulins, 94800, Villejuif, France.
| | - Florence Dalenc
- Institut Claudius Régaud, 1, Av Irène Joliot Curie, 31059, Toulouse, France.
| | - Audrey Mailliez
- Centre Oscar Lambret, 3, Rue Frédéric Combemale, 59000, Lille, France.
| | - Christelle Levy
- Centre François Baclesse, 3, Avenue du Général Harris, 14000, Caen, France.
| | - Véronique D'Hondt
- Institut du Cancer de Montpellier, 208, Av. Apothicaires, 34298, Montpellier, France.
| | - Marc Debled
- Institut Bergonié, 229, Cours de l'Argonne, 33000, Bordeaux, France.
| | | | - Bruno Coudert
- Centre Georges-François Leclerc, 1, Rue du Professeur Marion, 21079, Dijon, France.
| | - Christophe Perrin
- Centre Eugène Marquis, Avenue de la Bataille Flandre Dunkerque, 35042, Rennes, France.
| | - Anthony Gonçalves
- Institut Paoli-Calmettes, 232, BD Ste Marguerite, 13009, Marseille, France.
| | - Lionel Uwer
- Institut de Cancérologie de Lorraine, 6, Avenue Bourgogne, 54519, Vandoeuvre les Nancy, France.
| | - Jean-Marc Ferrero
- Centre Antoine Lacassagne, 33, Avenue de Valombrose, 06189, Nice, France.
| | | | - Thierry Petit
- Centre Paul Strauss, 3, Rue de la Porte de l'Hôpital, 67065, Strasbourg, France.
| | | | - Anne Patsouris
- Institut de Cancérologie de l'Ouest, site Paul Papin, 15, Rue André Boquel, 49055, Angers, France.
| | - Tahar Guesmia
- R&D Unicancer, 67 avenue Fontainebleau 94270 Le Kremlin Bicêtre, France.
| | | | - Mathieu Robain
- R&D Unicancer, 67 avenue Fontainebleau 94270 Le Kremlin Bicêtre, France.
| | - Paul Cottu
- Institut Curie, Paris-Saint Cloud, 26, Rue d'Ulm, 75005, Paris, France.
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Qiu SQ, van Rooijen J, Nienhuis HH, van der Vegt B, Timmer-Bosscha H, van Leeuwen-Stok E, Walenkamp AME, van Deurzen CHM, de Bock GH, de Vries EGE, Schröder CP. High hepatocyte growth factor expression in primary tumor predicts better overall survival in male breast cancer. Breast Cancer Res 2020; 22:30. [PMID: 32188473 PMCID: PMC7081628 DOI: 10.1186/s13058-020-01266-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2019] [Accepted: 03/09/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Breast cancer is rare in men, but management is focused on tumor characteristics commonly found in female breast cancer. The tumor microenvironment of male breast cancer is less well understood, and insight may improve male breast cancer management. The hepatocyte growth factor (HGF)/c-MET axis and the stromal cell-derived factor-1 (CXCL12)/C-X-C chemokine receptor type 4 (CXCR4) axis are prognostic in women with breast cancer. We aimed to investigate these factors in male breast cancer and correlate them with patient survival. METHODS From 841 Dutch males with breast cancer who were enrolled in the EORTC 10085/TBCRC/BIG/NABCG International Male Breast Cancer Program (NCT01101425) and diagnosed between 1990 and 2010, archival primary tumor samples were collected. Tissue microarrays were constructed with 3 cores per sample and used for immunohistochemical analysis of HGF, c-MET, CXCL12, and CXCR4. Overall survival (OS) of the patients without metastases (M0) was analyzed using the Kaplan-Meier method. The value of the markers regarding OS was determined using univariable and multivariable Cox regression analyses, providing hazard ratios (HRs) and 95% confidence intervals (95% CIs). RESULTS Of 720 out of 841 patients, sufficient tissue was available for analysis; 487 out of 720 patients had M0 disease. Patients with high HGF expression and high CXCL12 expression had a superior OS (low vs high expression of both markers, 7.5 vs 13.0 years, hazard ratio [HR] 0.64, 95% CI 0.49-0.84, P = 0.001 [HGF]; 9.1 vs 15.3 years, HR 0.63, 95% CI 0.45-0.87, P = 0.005 [CXCL12]). Multivariate analysis identified HGF as an independent predictor for OS (HR 0.64, 95% CI 0.47-0.88, P = 0.001). CONCLUSIONS HGF and CXCL12 tumor expression appear to identify male breast cancer patients with a relatively good prognosis. Possibly, this could support male breast cancer-specific management strategies in the future.
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Affiliation(s)
- Si-Qi Qiu
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
- Diagnosis and Treatment Center of Breast Diseases, Affiliated Shantou Hospital, Sun Yat-sen University, Shantou, China
- The Breast Center, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Johan van Rooijen
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
- Department of Internal Medicine, Martini Hospital Groningen, Groningen, The Netherlands
| | - Hilde H Nienhuis
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Bert van der Vegt
- Department of Pathology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Hetty Timmer-Bosscha
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | | | - Annemiek M E Walenkamp
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | | | - Geertruida H de Bock
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Elisabeth G E de Vries
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Carolien P Schröder
- Department of Medical Oncology, University of Groningen, University Medical Center Groningen, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
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