Abstract P4-07-21: Prognostic analysis of operable HR-positive HER2-negative loco-regional recurrent breast cancer; A multi-institutional Retrospective Cohort Study

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Abstract Background: Locoregional recurrence (LRR) after surgery in early-stage breast cancer patients is not uncommon。Several reports suggest that LRR in hormone receptor-positive HER2-negative breast cancer (HR+HER2- BC) has a better prognosis compared to other subtypes, however, studies on the prognosis of LRR in this subtype and factors affecting it are limited. Methods: Multicenter retrospective cohort study was conducted [te2] within the JCOG study group to assess the prognosis of HR+HER2- LRR and the factors affecting it. The study included patients diagnosed with HR+HER2- LRR at one or more sites, such as the ipsilateral breast, skin, chest wall, or regional lymph nodes following primary breast cancer surgery. All participants were free of distant metastases at LRR diagnosis and underwent radical surgery from January 2014 to December 2018. Results: Out of 967 enrolled patients across 41 centers, 946 were analyzed. There were 504 cases of ipsilateral breast tumor recurrence only (IBTR), while 442 had LRR at sites other than IBTR (oLRR). During a median follow-up period of 62.1 months, 239 invasive disease-free survival (iDFS) events and 80 deaths occurred. The 5-year iDFS rate for all LRR cases was 75.0%, and the 5-year overall survival (OS) rate was 92.3%. The 5-year iDFS was 83.4% for IBTR and significantly lower at 66.5% for oLRR. Multivariate analysis identified several independent prognostic factors for poorer iDFS: age over 60 years (HR: 1.43, 95% CI: 1.03-1.99) at LRR diagnosis, tumors with high Ki67 (>30) or high grade (HG3) (HR: 1.65, 95% CI: 1.19-2.27), and LRR diagnosis during adjuvant endocrine therapy (HR: 2.06, 95% CI: 1.30-3.66). For OS, poor prognostic factors included age over 60 (HR: 1.76, 95% CI: 1.04-2.98) or under 40 (HR: 2.31, 95% CI: 1.05-5.13) at LRR diagnosis, and tumors with high Ki67 or HG3 (HR: 2.25, 95% CI: 1.35-3.77). Conclusion: In this study, we investigated the prognosis and influencing factors of LRR in HR+ HER2- breast cancer using a large cohort of 946 cases, which has not been previously reported. Our findings highlight the imperative of tailored treatment strategies based on recurrence risk for HR+HER2- breast cancer patients experiencing LRR. Further randomized controlled trials are warranted to validate these strategies and improve the outcome in high-risk populations. Citation Format: Emi Tokuda, Yukinori Ozaki, Fumikata Hara, Shinsuke Sasada, Yasuaki Sagara, Masataka Sawaki, Chizuko Kanbayashi, Takashi Yamanaka, Tatsuya Onishi, Yoshitaka Fujiki, Akihiko Suto, Yuko Takahashi, Eriko Tokunaga, Tomoyuki Aruga, Rikiya Nakamura, Tomomi Fujisawa, Shigehira Saji, Hiroji Iwata, Tadahiko Shien. Prognostic analysis of operable HR-positive HER2-negative loco-regional recurrent breast cancer; A multi-institutional Retrospective Cohort Study [abstract]. In: Proceedings of the San Antonio Breast Cancer Symposium 2024; 2024 Dec 10-13; San Antonio, TX. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(12 Suppl):Abstract nr P4-07-21.

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