Research article

Tumor aromatase expression as a prognostic factor for local control in young breast cancer patients after breast-conserving treatment

Marc A Bollet¹ , Alexia Savignoni² , Leanne De Koning³ , Carine Tran-Perennou⁴ , Catherine Barbaroux⁴ , Armelle Degeorges⁴ , Brigitte Sigal-Zafrani⁴ , Geneviève Almouzni³ , Paul Cottu⁵ , Rémy Salmon⁶ , Nicolas Servant^7,8,9 , Alain Fourquet¹ and Patricia de Cremoux⁴

¹  Department of Radiation Oncology, Institut Curie, 26 rue d'Ulm, 75248 Paris, France

²  Department of Biostatistics, Institut Curie, 26 rue d'Ulm, 75248 Paris, France

³  Laboratory of Nuclear Dynamics and Genome Plasticity (UMR 218), Institut Curie, 26 rue d'Ulm, 75248 Paris, France

⁴  Department of Tumour Biology, Institut Curie, 26 rue d'Ulm, 75248 Paris, France

⁵  Department of Medical Oncology, Institut Curie, 26 rue d'Ulm, 75248 Paris, France

⁶  Department of Surgery, Institut Curie, 26 rue d'Ulm, 75248 Paris, France

⁷  Department of Bio-informatics, Institut Curie, 26 rue d'Ulm, 75248 Paris, France

⁸  INSERM, U900, 26 rue d'Ulm, 75248 Paris, France

⁹  Ecole des Mines de Paris, 35 rue Saint Honoré, 77300, Fontainebleau, France

author email corresponding author email

Breast Cancer Research 2009, 11:R54doi:10.1186/bcr2343

Published:	28 July 2009

Abstract

Introduction

We sought to determine whether the levels of expression of 17 candidate genes were associated with locoregional control after breast-conserving treatments of early-stage breast cancers in young, premenopausal women.

Methods

Gene expression was measured by using RT-PCR in the breast tumors of a series of 53 young (younger than 40 years), premenopausal patients. All treatments consisted of primary breast-conserving surgery followed by whole-breast radiotherapy (± regional lymph nodes) with or without systemic treatments (chemotherapy ± hormone therapy). The median follow-up was 10 years.

Results

The 10-year locoregional control rate was 70% (95% CI, 57% to 87%). In univariate analysis, no clinical/pathologic prognostic factors were found to be significantly associated with decreased locoregional control. Expression of three genes was found to be significantly associated with an increased locoregional recurrence rate: low estrogen-receptor β, low aromatase, and high GATA3. Two others were associated with only a trend (P < 0.10): low HER1 and SKP2. In multivariate analysis, only the absence of aromatase was significantly associated with an increased locoregional recurrence rate (P = 0.003; relative risk = 0.49; 95% CI 0.29 to 0.82).

Conclusions

Recent data give credit to the fact that breast cancer in young women is a distinct biologic entity driven by special oncogenic pathways. Our results highlight the role of estrogen-signaling pathways (mainly CYP19/aromatase, GATA3, and ER-β) in the risk of locoregional recurrence of breast cancer in young women. Confirmation in larger prospective studies is needed.