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

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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 languageEnglish
Pages (from-to)311-322
Number of pages12
JournalBreast Cancer Research and Treatment
Volume169
Issue number2
DOIs
Publication statusPublished - 2018 Jun 1

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Carcinoma, Intraductal, Noninfiltrating
Tamoxifen
Registries
Databases
Breast Neoplasms
Survival
Progesterone Receptors
Group Psychotherapy
Estrogen Receptors
Therapeutics
Survival Rate
Multivariate Analysis
Survival Analysis
Proportional Hazards Models
Statistical Factor Analysis

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

@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 Byeongwoo Park and Noh, {Woo Chul} and Yoon, {Jung Han} and Lee, {Soo Jung} and Lee, {Eun Kyu} and Jeong Joon 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}",
year = "2018",
month = "6",
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",

}

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, Byeongwoo

AU - Noh, Woo Chul

AU - Yoon, Jung Han

AU - Lee, Soo Jung

AU - Lee, Eun Kyu

AU - Joon, Jeong

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

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

M3 - Article

C2 - 29383628

AN - SCOPUS:85041206928

VL - 169

SP - 311

EP - 322

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 2

ER -