Prognostic value of molecular subtypes and other factors on disease-free survival in women with breast cancer at Universiti Sains Malaysia Hospital

Introduction: Breast cancer is the most common cancer in Malaysia with a 5-year incidence of 18,206 patients during 2007-2011. Approximately 2,572 patients died of breast cancer in 2012 in Malaysia. Objective: The study assessed the five-year disease-free survival (5-y DFS), distribution of molecul...

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Main Author:	Wei, Oh Chen
Format:	Thesis
Language:	English
Published:	2018
Subjects:	RG Gynecology and obstetrics
Online Access:	http://eprints.usm.my/47823/1/Dr.%20Oh%20Chen%20Wei-24%20pages.pdf
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spelling	my-usm-ep.478232020-10-28T07:27:14Z Prognostic value of molecular subtypes and other factors on disease-free survival in women with breast cancer at Universiti Sains Malaysia Hospital 2018-04 Wei, Oh Chen RG Gynecology and obstetrics Introduction: Breast cancer is the most common cancer in Malaysia with a 5-year incidence of 18,206 patients during 2007-2011. Approximately 2,572 patients died of breast cancer in 2012 in Malaysia. Objective: The study assessed the five-year disease-free survival (5-y DFS), distribution of molecular subtypes and other prognostic factors of breast cancer. Methods: A single-center retrospective review was conducted on 208 patients with non-metastatic, operable breast cancer treated with mastectomy or breast-conserving surgery between 2007 and 2015. Data collected included patients’ demographics, tumour’s characteristics, histopathological profiles, receptor status and treatment modalities. Molecular subtypes of breast cancer were subdivided into four groups: Luminal A: ER+ and/or PR+ and HER2- Luminal B: ER+ and/or PR+ and HER2+; HER-2 enriched: ER-, PR- and HER2+; Triple negative: ER-, PR- and HER2-. Ratio of positive lymph nodes (LNs) and dissected LNs was classified as 0, ≤0.20, >0.20 and ≤ 0.65 and > 0.65. Kaplan-Meier survival analysis was performed. Cox proportional hazards regression was used to determine prognosis factor. Result: The distribution of molecular subtypes among 208 patients was: Luminal A (35.2%), Luminal B (29.0%), HER2-enriched (18.1%), and Triple-negative (17.6%). In univariable analysis, the molecular subtype was not associated with DFS. However, both absolute number of positive lymph nodes and the LNR were significant prognostic factors of DFS. In multivariable analysis, the positive LNs lost significance and the LNR remained as a prognostic factor of DFS, patients had increased risk (aHR: 1.17; 95% CI: 1.10 - 1.26) to experience any recurrence or death for every increasing of 0.1 unit in LNR when radiotherapy was adjusted for. Conclusion: The present study reported the Luminal type breast cancer was the most common subtype of breast cancer among female patients. The study also demonstrates that LNR is a better prognostic factor in predicting DFS than the absolute number of positive LNs. Molecular subtype is not a significant prognostic factor. 2018-04 Thesis http://eprints.usm.my/47823/ http://eprints.usm.my/47823/1/Dr.%20Oh%20Chen%20Wei-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution	Universiti Sains Malaysia
collection	USM Institutional Repository
language	English
topic	RG Gynecology and obstetrics
spellingShingle	RG Gynecology and obstetrics Wei, Oh Chen Prognostic value of molecular subtypes and other factors on disease-free survival in women with breast cancer at Universiti Sains Malaysia Hospital
description	Introduction: Breast cancer is the most common cancer in Malaysia with a 5-year incidence of 18,206 patients during 2007-2011. Approximately 2,572 patients died of breast cancer in 2012 in Malaysia. Objective: The study assessed the five-year disease-free survival (5-y DFS), distribution of molecular subtypes and other prognostic factors of breast cancer. Methods: A single-center retrospective review was conducted on 208 patients with non-metastatic, operable breast cancer treated with mastectomy or breast-conserving surgery between 2007 and 2015. Data collected included patients’ demographics, tumour’s characteristics, histopathological profiles, receptor status and treatment modalities. Molecular subtypes of breast cancer were subdivided into four groups: Luminal A: ER+ and/or PR+ and HER2- Luminal B: ER+ and/or PR+ and HER2+; HER-2 enriched: ER-, PR- and HER2+; Triple negative: ER-, PR- and HER2-. Ratio of positive lymph nodes (LNs) and dissected LNs was classified as 0, ≤0.20, >0.20 and ≤ 0.65 and > 0.65. Kaplan-Meier survival analysis was performed. Cox proportional hazards regression was used to determine prognosis factor. Result: The distribution of molecular subtypes among 208 patients was: Luminal A (35.2%), Luminal B (29.0%), HER2-enriched (18.1%), and Triple-negative (17.6%). In univariable analysis, the molecular subtype was not associated with DFS. However, both absolute number of positive lymph nodes and the LNR were significant prognostic factors of DFS. In multivariable analysis, the positive LNs lost significance and the LNR remained as a prognostic factor of DFS, patients had increased risk (aHR: 1.17; 95% CI: 1.10 - 1.26) to experience any recurrence or death for every increasing of 0.1 unit in LNR when radiotherapy was adjusted for. Conclusion: The present study reported the Luminal type breast cancer was the most common subtype of breast cancer among female patients. The study also demonstrates that LNR is a better prognostic factor in predicting DFS than the absolute number of positive LNs. Molecular subtype is not a significant prognostic factor.
format	Thesis
qualification_level	Master's degree
author	Wei, Oh Chen
author_facet	Wei, Oh Chen
author_sort	Wei, Oh Chen
title	Prognostic value of molecular subtypes and other factors on disease-free survival in women with breast cancer at Universiti Sains Malaysia Hospital
title_short	Prognostic value of molecular subtypes and other factors on disease-free survival in women with breast cancer at Universiti Sains Malaysia Hospital
title_full	Prognostic value of molecular subtypes and other factors on disease-free survival in women with breast cancer at Universiti Sains Malaysia Hospital
title_fullStr	Prognostic value of molecular subtypes and other factors on disease-free survival in women with breast cancer at Universiti Sains Malaysia Hospital
title_full_unstemmed	Prognostic value of molecular subtypes and other factors on disease-free survival in women with breast cancer at Universiti Sains Malaysia Hospital
title_sort	prognostic value of molecular subtypes and other factors on disease-free survival in women with breast cancer at universiti sains malaysia hospital
granting_institution	Universiti Sains Malaysia
granting_department	Pusat Pengajian Sains Perubatan
publishDate	2018
url	http://eprints.usm.my/47823/1/Dr.%20Oh%20Chen%20Wei-24%20pages.pdf
_version_	1747821836071075840

Prognostic value of molecular subtypes and other factors on disease-free survival in women with breast cancer at Universiti Sains Malaysia Hospital

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