Mortality and recurrence rates among systemically untreated high risk breast cancer patients included in the DBCG 77 trials

Figures & data

Table 1. Patient and tumor characteristics by subtype.

			Subtype
	Total		Luminal A		Luminal B		HER2E		Core basal		NA
Characteristics	N	%	N	%	N	%	N	%	N	%	N	%
No. of patients	1100		199		419		84		43		355
Age
<50	187	17	13	7	58	14	9	11	8	19	99	28
50–59	272	25	51	26	84	20	34	40	9	21	94	26
60–69	370	34	66	33	162	39	29	35	14	33	99	28
≥70	271	25	69	35	115	27	12	14	12	28	63	18
Lymph node status
Negative	152	14	25	13	49	12	7	8	9	21	62	17
1–3 positive	591	54	118	59	220	53	44	52	19	44	190	54
4–9 positive	264	24	40	20	117	28	22	26	12	28	73	21
≥10 positive	39	4	6	3	17	4	8	10	1	2	7	2
Unknown	54	5	10	5	16	4	3	4	2	5	23	6
Total lymph nodes
0 retrieved	54	5	10	5	16	4	3	4	2	5	23	6
1–3 retrieved	259	24	48	24	92	22	17	20	7	16	95	27
4–9 retrieved	610	55	113	57	240	57	44	52	25	58	188	53
≥10 retrieved	177	16	28	14	71	17	20	24	9	21	49	14
Tumor size
0–20 mm	289	26	60	30	104	25	18	21	8	19	99	28
21–50 mm	587	53	106	53	233	56	47	56	25	58	176	50
>50 mm	213	19	33	17	78	19	19	23	10	23	73	21
Unknown	11	1	0	0	4	1	0	0	0	0	7	2
Deep fascia invasion
Absent	818	74	168	84	307	73	60	71	30	70	253	71
Present	275	25	31	16	111	26	24	29	12	28	97	27
Unknown	7	1	0	0	1	0	0	0	1	2	5	1
Histologic type
Ductal carcinoma	975	89	186	93	364	87	75	89	35	81	315	89
Lobular carcinoma	48	4	9	5	21	5	3	4	0	0	15	4
Other	77	7	4	2	34	8	6	7	8	19	25	7
Malignancy grade^a
Grade I	275	28	82	44	103	28	9	12	2	6	79	25
Grade II	534	55	94	51	205	56	47	63	16	46	172	55
Grade III	162	17	10	5	56	15	18	24	15	24	63	20
Unknown	4	0	0	0	0	0	1	1	2	6	1	0

HER2E: Her2-Enriched.

^a Ductal carcinoma only.

Figure 1. (Panel A) Cumulative Incidence estimates for recurrence (Rec) of systemically untreated patients with luminal A (Lum A), luminal B (Lum B), HER2-Enriched (HER2) and core basal (CB) breast cancer. (Panel B) Kaplan–Meier estimates of overall survival for systemically untreated patients with luminal A (Lum A), luminal B (Lum B), HER2-Enriched (HER2) and core basal (CB) breast cancer. Estimates for OS at 5, 10 and 20 years after surgery; Lum A 67% (60;73), 46% (39;53), 20% (14;25), Lum B 56% (51;61), 28% (24;33), 13% (10;16), HER2E 41% (30;51), 31% (21;41), 21% (13;31), core basal 42% (27;56), 35% (21;49), 16% (7;29). (Panel C) Kaplan–Meier estimates of disease-free survival (considering events of recurrence, contralateral breast cancer, other malignancy, and death as first event) for systemically untreated patients with luminal A (Lum A), luminal B (Lum B), HER2-Enriched (HER2) and core basal (CB) breast cancer. Patients at risk according to time after surgery listed below x-axis.

Table 2. Proportional hazards models for recurrence and overall survival according to subtype.

		Years after surgery
Subtype	p	HR	95% CI	HR	95% CI	HR	95% CI	Pheterogeneity
Recurrence		0–2½		2½–10
Univariate	<.0001
Luminal A		0.63	(0.43;0.90)	0.67	(0.47;0.96)			.78
Luminal B		Reference
HER2E		1.97	(1.35;2.88)	0.39	(0.18;0.85)			.0002
Core basal		1.55	(0.93;1.60)	0.36	(0.13;1.02)			.01
Multivariate	.001
Luminal A		0.79	(0.55;1.13)	0.69	(0.47;1.00)			.61
Luminal B		Reference
HER2E		1.66	(1.11;2.49)	0.35	(0.16;0.76)			.0004
Core Basal		1.44	(0.84;2.47)	0.40	(0.14;1.15)			.03
OS		0–5		5–10		>10
Univariate	<.0001
Luminal A		0.67	(0.51;0.87)	0.57	(0.41;0.81)	1.09	(.84;1.42)	.03
Luminal B		Reference
HER2E		1.75	(1.29;2.37)	0.44	(0.22;0.89)	0.61	(.39;.95)	<.0001
Core Basal		1.60	(1.06;2.42)	0.30	(0.10;0.94)	0.60	(.32;1.10)	.002
Multivariate	p < .0001
Luminal A		0.79	(0.60;1.03)	0.60	(0.43;0.85)	0.97	(.75;1.26)	.08
Luminal B		Reference
HER2E		1.72	(1.26;2.34)	0.46	(0.22;0.93)	0.48	(.31;.75)	<.0001
Core Basal		1.55	(1.01;2.37)	0.36	(0.11;1.11)	0.63	(.34;1.16)	.008

HER2E: Her2-Enriched; HR: hazard ratio; CI: confidence interval; OS: overall survival.

Hazard ratios for unadjusted and adjusted estimates. p Values for overall significance and for test of heterogeneity in relation to years after surgery (non-proportional hazard).

Table 3. Standardized mortality ratio according to subtype, overall and in relation to years after surgery.

	Years after surgery
	0–5		5–10		>10		Overall
Subtype	SMR	95% CI	SMR	95% CI	SMR	95% CI	SMR	95% CI
Lum A	3.20	(2.52;4.08)	2.14	(1.58;2.91)	1.76	(1.43;2.17)	2.18	(1.89;2.51)
Lum B	5.13	(4.43;5.92)	4.46	(3.73;5.35)	1.65	(1.37;2.00)	3.23	(2.93;3.55)
HER2E	13.0	(9.87;17.2)	2.53	(1.26;5.05)	0.88	(0.58;1.33)	2.50	(2.01;3.11)
Core Basal	10.1	(6.81;14.9)	1.35	(0.44;4.19)	1.07	(0.59;1.93)	2.60	(1.90;3.56)

Lum A: luminal A; Lum B: luminal B; HER2E: Her2-Enriched; CI: confidence interval; SMR: standardized mortality ratio.