Research article
Tumor aromatase expression as a prognostic factor for local control in young breast cancer patients after breast-conserving treatment
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* Corresponding author: Marc A Bollet marc.bollet@curie.net
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
Breast Cancer Research 2009, 11:R54 doi:10.1186/bcr2343
Published: 28 July 2009Abstract
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.