P2-12-07: Pooled Analysis of Outcomes of T1a/bN0, HER2−Amplified Breast Cancer.
Bibliographic record
Abstract
Abstract Background: Breast tumors with HER2 amplification have a worse prognosis than those with normal HER2 expression. This finding is independent of tumor size and other classical prognostic factors used in the adjuvant setting. The prognosis of node negative, sub-centimeter (T1a/bN0) tumors is usually excellent. However, little is known about the prognostic impact of HER2−amplification in this group. This study therefore, aimed to evaluate the relative and absolute prognostic impact of HER2−amplification in T1a/bN0 tumors. Materials and Methods: Published data from studies assessing the outcomes of patients with HER2−amplified, node negative, T1a/bN0 tumors were included in a pooled analysis. Odds ratios (OR), 95% confidence intervals (CI) and absolute risks were computed for recurrence and distant recurrence at 5 years. Pooled hazard ratios (HR) for disease-free survival (DFS), were also assessed. Results: A total of 3 case-control studies were included in the analysis and comprised 485 patients with HER2−amplified breast cancer (57.3% were also hormone receptor positive) and 1096 patients with HER2−normal disease (82.2% were hormone receptor positive). Among the HER2−amplified group, 4.1% received trastuzumab and 18.6% received chemotherapy. In the HER2−normal group, 4.3% received chemotherapy Estimated median follow-up was 5.7 years. HER2−amplification was associated worse DFS (HR = 2.60, 95% CI 1.53−4.41, p<.001) and increased odds for recurrence at 5 years (OR = 3.79, 95% CI 2.35−6.10, p<.001). There was a non-significant trend towards increased odds of distant recurrence at 5 years (OR = 2.51, 95% CI 0.82−7.67, p=.11). Compared with HER2−normal cancers, those with HER2−amplification showed lower absolute probability of recurrence-free survival at 5 years (90.1% vs. 94.6%, p<.001) and distant recurrence-free survival at 5 years (95.1% vs. 97.6%, p<.001). Among HER2−amplified cancers, tumor size 0.6−1.0cm (T1b) was associated with a trend for higher odds of recurrence at 5 years compared with those 0.5cm or smaller (T1a, pooled OR = 1.58, 95% CI 0.96−2.60, p=.07). Conclusions: HER2−amplification is associated with worse outcome in T1a/bN0 tumors. However, recurrence-free and distant recurrence-free survival at 5 years is excellent in this group, particularly in those with T1a tumors. These data question the role of adjuvant chemotherapy and trastuzumab in these patients unless associated with other high risk features. A differentially lower risk for distant recurrence suggests the possible role for more aggressive local therapy such as surgery and/or radiation therapy. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-12-07.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.020 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.023 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".