Research Papers:

Luminal-like HER2-negative stage IA breast cancer: a multicenter retrospective study on long-term outcome with propensity score analysis

Carmine De Angelis, Massimo Di Maio, Anna Crispo, Mario Giuliano, Francesco Schettini, Marta Bonotto, Lorenzo Gerratana, Donatella Iacono, Marika Cinausero, Ferdinando Riccardi, Giuseppe Ciancia, Michelino De Laurentiis, Fabio Puglisi, Sabino De Placido and Grazia Arpino _

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Oncotarget. 2017; 8:112816-112824. https://doi.org/10.18632/oncotarget.22643

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Carmine De Angelis1, Massimo Di Maio2, Anna Crispo3, Mario Giuliano1,4, Francesco Schettini4, Marta Bonotto5, Lorenzo Gerratana6, Donatella Iacono5, Marika Cinausero6, Ferdinando Riccardi7, Giuseppe Ciancia8, Michelino De Laurentiis9, Fabio Puglisi6,10, Sabino De Placido4 and Grazia Arpino4

1Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, Texas 77030, USA

2Oncology Department, University of Turin, 10043 Orbassano, Italy

3Epidemiology Department, ‘Fondazione G. Pascale’ Istituto Nazionale Tumori, 80131 Naples, Italy

4Clinical Medicine and Surgery Department, University of Naples Federico II, 80131 Naples, Italy

5Department of Medical and Biological Sciences, University of Udine, 33100 Udine, Italy

6Department of Medicine (DAME), University of Udine, 33100 Udine, Italy

7Medical Oncology Unit, Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, 80131 Naples, Italy

8Advanced Biomedical Sciences Department, University of Naples Federico II, 80131 Naples, Italy

9Breast Unit, ‘Fondazione G. Pascale’ Istituto Nazionale Tumori, 80131 Naples, Italy

10Department of Clinical Oncology, CRO Aviano National Cancer Institute, 33081 Aviano, Italy

Correspondence to:

Grazia Arpino, email: [email protected]

Keywords: breast cancer; luminal-like; chemotherapy; hormone therapy; propensity score

Received: July 22, 2017    Accepted: October 28, 2017    Published: November 24, 2017


The benefit of adding chemotherapy (CT) to adjuvant hormone therapy (HT) in stage IA luminal-like HER2-negative breast cancer (BC) is unclear. We retrospectively evaluated predictive factors and clinical outcome of 1,222 patients from 4 oncologic centers. Three hundred and eighty patients received CT and HT (CT-cohort) and 842 received HT alone (HT-cohort). Disease-free survival (DFS) and overall survival (OS) were evaluated with univariate and multivariate analyses. We also applied the propensity score methodology. Compared with the HT-cohort, patients in the CT-cohort were more likely to be younger, have larger tumors of a higher histological grade that were Ki67-positive, and lower estrogen and progesterone receptor expression. At univariate analysis, a higher histological grade and Ki67 were significantly associated to a lower DFS. At multivariable analysis, only histological grade was predictive of DFS. The CT-cohort had a worse outcome than the HT-cohort in terms of DFS and OS, but differences disappeared when matched according to propensity score. In summary, patients with stage IA luminal-like BC had an excellent prognosis, however relapse and mortality were higher in the CT-cohort than in the HT-cohort. Longer use of adjuvant HT or other therapeutic strategies may be needed to improve outcome.

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