New prognostic factors and long-term prognosis of different breast cancer subtypes

Thesis event information

Date and time of the thesis defence

Place of the thesis defence

Auditorium F202 of the Faculty of Medicine (Aapistie 5 B)

Topic of the dissertation

New prognostic factors and long-term prognosis of different breast cancer subtypes

Doctoral candidate

Licentiate of Medicine Anniina Jääskeläinen

Faculty and unit

University of Oulu Graduate School, Faculty of Medicine, Cancer and Translational Medicine Research Unit

Subject of study

Clinical oncology

Opponent

Professor Heikki Joensuu, The University of Helsinki/HUS Comprehensive Cancer Center

Custos

Professor Peeter Karihtala, The University of Helsinki/HUS Comprehensive Cancer Center

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New prognostic factors and long-term prognosis of different breast cancer subtypes

Breast cancer is the most common women’s malignancy worldwide, affecting approximately 5
000 new patients in Finland yearly. Breast cancer includes a range of biologically varying diseases
with different clinical characteristics and patient outcomes. Despite the overall excellent prognosis due to effective screening and advancements in treatment modalities, a small subset of aggressive cancers continues to challenge the current concepts of treatment, and metastatic breast cancer remains incurable to date. The differences observed in breast cancer prognosis between the intrinsic subtypes highlight the need for an increased understanding of their biological heterogeneity. New prognostic markers to facilitate clinical decision-making for subgroups with less favourable prognoses are required.

The aim of this study was to evaluate the use of the tight-junction proteins claudins, the androgen, mineralocorticoid and glucocorticoid β receptors and type I collagen metabolism markers as new prognostic markers for different breast cancer subtypes for early breast cancer. According to the results, it seems that high-level cytoplasmic claudin 3 expression may be an independent predictor of poor survival in triplenegative breast cancer. Also, elevated preoperative serum levels of collagen I carboxyterminal telopeptide are associated with better outcomes in early-stage luminal B-like (HER2-negative) and triple-negative breast cancers. In addition, cytoplasmic mineralocorticoid receptor expression predicts dismal local relapse-free survival in non-triple-negative breast cancer. This study also assessed the use of patient reproductive history in the prognostic evaluation of different breast cancer subtypes of early breast cancer. It was observed that high parity is associated with poor outcomes in patients with luminal B-like (HER2-negative) early breast cancer. Finally, this study presents real-world data on the early breast cancer survival rates for the five intrinsic subtypes in patients treated in Oulu University Hospital. To conclude, the overall 10-year breast cancerspecific survival rate was 91.4%. However, the difference between the subtype with the best (luminal A-like, 97.9%) and the worst (luminal B-like HER2-positive, 80.6%) 10-year outcome was notable.
Last updated: 24.5.2022