Poster presentation

1. Prognostic factors among ER+ HER2- breast cancer patients in Malaysia
Y.Y. Lee1, N.A.M. Taib2, S.S. Yeoh1, C.H. Yip2, N. Bhoo-Pathy3
1Outcome and Evidence, Pfizer Malaysia , 2Surgery, University of Malaya Faculty of Medicine,3Social and Preventive Medicine, University of Malaya, Kuala Lumpur, MY
Background Results
Breast cancer is a multifaceted disease with diverse clinical,
pathologic and molecular features which led to different
prognostic outcomes. We aim to examine factors that
influence survival outcome among ER+ HER2- patients from
a single institution.
Methods
• Data of patients diagnosed between January 1, 2005 to
December 1, 2011 was extracted from the University
Malaya Medical Centre Breast Cancer Registry.
• Kaplan-Meier method was used to estimate overall
survival. Overall survival was defined from date of
diagnosis to date of death from any cause.
• Log rank tests and Cox hazards regression model were
used to compare survival and identify prognostics
factors.
• Stage 4 patients were excluded from univariate and
multivariate analysis
Conclusion
• In this cohort, we found increasing age, tumor
size and number of lymph node was associated
with poorer survival outcome among ER+/HER2-
breast cancer patients.
• Ethnic disparities in survival outcome were not
apparent in this molecular subset.
• Women who undergone surgery had 71% greater
survival outcome
Table 1 5 year survival probability among ER+/HER2- breast cancer patients
Results
• A total of 951 patients with ER+/HER2- breast cancer
were available for analysis
• Median age at diagnosis was 54 years (range, 24-89)
• Overall survival was 8.4 years (8.2-8.6)
• Median follow up time was 5.2 years (0.08-10.1)
• Ethnicity and grade were not associated with survival
outcome
N=951
5 year survival probability p-value
logrank% 95% CI
Age, years <40 87.2 76.8-93.2 0.0021
40-49 88.9 84.4-92.2
50-59 81.2 75.9-85.5
60-69 82.5 76.3-87.2
>70 71.8 59.6-80.8
Race Chinese 85.4 81.6-88.4 0.83
Indian 77 67.9-83.8
Malay 83.3 78.7-87
Surgery No 43.8 32.3-54.7 <0.001
Yes 87.2 84.6-89.4
Lumpectomy 92 87.4-95 0.0016
Mastectomy 86.6 80.3-86.4
Adjuvant hormone therapy No 80.6 64.3-90 0.026
Yes 87.7 85-89.9
Adjuvant chemotherapy No 84.3 79.9-87.8 0.81
Yes 82.8 79-86
Anthracycline 82.7 78-86.5 0.41
Taxane based 86 78.7-90.0
Stage 1 95.4 91.7-97.4 <0.001
2 88.6 84.7-91.6
3 74.9 68.3-80.4
4 27.5 16.1-40.1
Grade 1 87.1 78.6-92.4 0.0072
2 85.2 81.2-88.3
3 77.8 70.8-83.4
Size, cm T1 (<2 cm) 94.8 90.9-97 <0.001
T2 (2-5 cm) 84 80.2-87.1
T3 (>5 cm) 64.2 55.9-71.3
Lymph node <0.001
Negative 95.2 92.6-96.8
Positive 75.9 71.1-80
N1 (1-3 LN) 80.5 73.8-85.7 <0.001
N2 (4-9 LN) 74.9 65.4-82.1
N3 (≥ 10 LN) 66.1 54.2-75.7
HR 95% CI p-value
Age 1.03 1.01-1.05 0.003
Hormone therapy 0.62 0.25-1.55 0.30
Surgery 0.29 0.13-0.64 0.002
Size T2 (2-5 cm) 2.57 1.33-4.96 0.005
Size T3 (>5 cm) 3.26 1.53-6.96 0.002
Lymph node, N1 (1-3 LN) 2.70 1.64-4.46 <0.001
Lymph node, N2 (4-9 LN) 2.26 1.27-4.03 0.006
Lymph node, N3 (≥ 10 LN) 3.67 2.01-6.69 <0.001
Grade 2 1.06 0.58-1.95 0.84
Grade 3 1.13 0.57-2.24 0.72
Table 2 Multivariate analysis of prognostic factors
73P
Figure 2 Univariate analysis of prognostic factors
Funding acknowledgement
Ministry of Education, Malaysia - High Impact
Research Grant [UM.C/HIR/MOHE/06]
N3 (≥ 10 LN)
N2 (4-9 LN)
N1 (1-3 LN)
Positive lymph node
T3 (>5 cm)
T2 (2-5 cm)
Grade 3
Grade 2
Stage 3
Stage 2
Taxane based
Anthracycline
Chemotherapy
Hormone therapy
Mastectomy
Lumpectomy
Surgery
Malay
Indian
>70
60-69
50-59
40-49
Age, years
-4 -2 0 2 4 6 8 10
Hazard ratios
Reference groups: Hormone therapy – No, Surgery – No, Size - T1, Lymph node – N0, Grade 1