Treatment Strategies in Women with Node-Negative Oestrogen ReceptorPositive Human Epidermal Receptor 2-Negative Breast Cancers

Background: Women with node-negative ER-positive/HER2negative breast cancers respond well to hormonal therapy and generally have a good prognosis. The low frequency of events has led to re-evaluations of the need for chemotherapy in addition to hormonal therapy. In this study, we reviewed the long-term outcomes of women with ER-positive/HER2-negative tumours and evaluated factors associated with outcome, specifically that of hormonal therapy, alone or in combination with chemotherapy.

Methods: We identified 117 women with available longterm follow up data from our prospective database. Endpoints examined included disease recurrence, contralateral breast cancer and overall survival. These were correlated with standard clinicopathological parameters and treatments received.

Findings: Median overall survival was 128.23 months (ranging from 12.87 to 143.20 months). Recurrence developed in 14 women (12.0%) and contralateral breast cancer in another 7; events had developed after 5 years in 13 women. The majority of women (89 of 117) received hormonal therapy and 27 women also received chemotherapy. Chemotherapy produced a small nonsignificant effect on 10 year recurrence-free and event-free survival (P=0.295 and P=0.443, respectively). Lymphovascular invasion was the only factor with an independent association with 10 year recurrence-free and event-free survival (P=0.038 and P=0.009, respectively). Tumour size, grade and progesterone receptor status showed no association. Seventy-three women completed at least 5 years of hormonal treatment, which was found to significantly improve 10 year event-free survival (P=0.005).

Conclusion: Many women with node-negative ER-positive/ HER2 negative have a good prognosis on hormonal therapy alone.

Author(s): Patrick MY Chan, Pei Yi Sin, Juliana JC Chen, Mui Heng Goh, Sarah QH Lu and Ern Yu Tan

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