Combined impact of patients and disease characteristics on survival outcome in early hormone receptor negative patients across SBR grades.

Abstract

e12525 Background: Previous studies have established a correlation between Scarff-Bloom-Richardson (SBR) grades, cell proliferation, and chemo-response in Breast Cancer before or after surgery. However, the impact of additional pathological signatures for each SBR grade remains underexplored due to insufficient clinical evidence. This study seeks to investigate the impact of various characteristics on treatment outcomes and survival in hormone receptor-negative (HR-) patients, stratified by SBR grades. Methods: We retrospectively selected stage I, II, and III early HR- patients aged over 18 years, treated between January 2020 and December 2022. All patients underwent surgery followed by sequential anthracyclines-taxanes and radiotherapy if indicated. The primary endpoint was to identify significant differences in patient characteristics while controlling for SBR grades. The secondary endpoint focused on evaluating time to recurrence and treatment outcomes. Results: A total of 324 patients met the inclusion criteria, with a median age of 50 years (IQR: 42, 58). Over a median follow-up period of 31 months (IQR: 25, 37), significant associations were observed between SBR grade and histology type (p = 0.060), tumor grade ( < 0.001), Human Epidermal Receptor 2 (HER2) status (p = 0.077), and recurrence events (p = 0.003). Patients with high SBR grades (III) were more likely to present with vascular emboli (p = 0.032) and had a higher incidence of local recurrence (p = 0.006) and lung metastasis (p = 0.038). In contrast, patients with low SBR grades (I and II) tended to lack vascular emboli and presented more frequently with intermediate ductal histology, HER2 0 status, and bone metastasis. A significant difference in disease-free survival (DFS) was noted, with a median DFS of 32 months (95% CI, 29 to NE) for lower SBR grades and 29 months (95% CI, 26 to NE) for higher SBR grades. The 36-month DFS rate was 60% (95% CI, 44 to 81) for lower SBR grades and 36% (95% CI, 18 to 70) for higher SBR grades. There was a lack of statistical significance impact of different chemotherapeutic regimens and radiotherapy on DFS regardless SBR grades. Overall survival (OS) could not be assessed due to the immaturity of the data. Conclusions: These findings underscore the importance of considering SBR grade, histological types, and vascular emboli in the personalized management of HR- breast cancer to improve treatment outcomes and survival rates. Further research is needed to explore the molecular mechanisms underlying these associations and validate our findings in larger, multi-center cohorts.