Prognostic analysis of endocrine therapy for breast cancer with low estrogen receptor expression
10.12354/j.issn.1000-8179.2025.20250723
- VernacularTitle:内分泌治疗雌激素受体低表达乳腺癌患者的预后分析
- Author:
Zhang LEI
1
;
Zhang MENG
1
;
Liu YING
1
;
Nuertai ZINATI
1
;
Cheng FANG
1
Author Information
1. 新疆医科大学附属肿瘤医院综合/特需科(乌鲁木齐市 830000)
- Publication Type:Journal Article
- Keywords:
breast cancer;
estrogen receptor-low expression;
endocrine therapy;
prognosis
- From:
Chinese Journal of Clinical Oncology
2025;52(13):660-667
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the impact of endocrine therapy(ET)on the prognosis of breast cancer patients with low estrogen re-ceptor(ER)expression and to identify the associated independent prognostic factors.Methods:We retrospectively analyzed the clinicopath-ological data of 387 female patients with breast cancer with low ER expression and at stage Ⅰ-Ⅲ TNM who were treated surgically at Xinji-ang Medical University Affiliated Tumor Hospital between January 2014 and May 2020.The patients were stratified into ET and non-ET groups based on whether they received ET administration.Propensity score matching(PSM)was used to balance intergroup differences,and survival analysis along with Cox proportional hazards models were applied to assess prognosis and the associated independent influencing factors.Results:Among the 387 patients,214(55.3%)received ET and 173(44.7%)did not.Baseline data indicated that the non-ET group exhibited higher proportions of ethnic minorities and patients with regional lymph node involvement,advanced TNM stage,and no radio-therapy administration.After PSM,baseline characteristics showed no significant differences between the ET(n=132)and non-ET groups(n=132).Pre-PSM survival analysis revealed 5-year overall survival(OS)rates of 93.4%and 72.8%and 5-year disease-free survival(DFS)rates of 74.1%and 60.9%for the ET and non-ET groups,respectively;both rates showed statistically significant differences between the groups(P<0.05).Post-PSM,the 5-year OS rates significantly differed between the ET and non-ET groups(91.6%and 80.1%,respectively;P<0.05),whereas no significant difference in 5-year DFS rates were observed(71.1%[ET group]vs.68.1%[non-ET group],P>0.05).Multivariate ana-lysis identified the following independent prognostic factors:for OS,ET administration,CK5/6 status,tumor size T3,lymph node status N2/N3,and radiotherapy administration(all P<0.05).For DFS,the independent factors included CK5/6 status,tumor size T3,lymph node status N2/N3,radiotherapy administration,and targeted therapy(all P<0.05).Conclusions:Endocrine therapy significantly improved the 5-year OS in breast cancer patients with low ER expression.CK5/6 positivity,large tumor size(T3),and regional lymph node involvement(N2/N3)were independent risk factors for both 5-year OS and DFS.Adjuvant radiotherapy and trastuzumab-based therapy significantly im-proved prognosis.
