Evolving incidence patterns for locally advanced operable breast cancer by receptor status: SEER 2010–2021
Tumor biologic risk has replaced anatomic disease burden for guiding chemotherapy use in HR-positive, early-stage breast cancer. Recent surgical trials support less frequent axillary lymph node dissection, potentially impacting incidence of N2-3 diagnoses. As the field considers applying genomic risk assessment tools for locally advanced, operable HR-positive breast cancer, we estimated current incidence of these cancers, focusing on HR-positive/HER2-negative disease. Of 486,031 cases recorded with Stage I-III HR-positive/HER2-negative disease in the U.S. National Cancer Institute Surveillance, Epidemiology, and End Results-17 database (2010-2021), 28,585 (5.9%) and 23,307 (4.8%) had N2-3M0(Any T) and T3-4N0-1M0 disease, respectively. Invasive lobular cancer, observed across all disease stages and receptor-based subtypes, was highest in HR-positive/HER2-negative locally advanced disease. Incidence of N2-3M0(Any T) decreased for each subtype. Incidence of T3-4N0-1M0 increased for HR-positive/HER2-negative disease but not for the other subtypes. Defining chemotherapy benefit for patients with locally advanced, operable HR-positive breast cancer remains an important clinical question.
Authors
- Giuseppe Curigliano (ORCID: https://orcid.org/0000-0003-1781-2518)
- Angela M. DeMichele (ORCID: https://orcid.org/0000-0003-1297-4251)
- Michail Ignatiadis
- Anthony Rhoads (ORCID: https://orcid.org/0000-0001-6510-9638)
- Alexandra Thomas (ORCID: https://orcid.org/0000-0001-9022-2229)
- Séamus O’Reilly (ORCID: https://orcid.org/0000-0002-2887-7336)
- Nadia Harbeck (ORCID: https://orcid.org/0000-0002-9744-7372)
- Yang Zhou (ORCID: https://orcid.org/0000-0001-6867-6443)
- Paul A. Romitti (ORCID: https://orcid.org/0000-0001-5393-9984)
- Kevin Kalinsky (ORCID: https://orcid.org/0000-0002-3113-7902)
- Erica L. Mayer (ORCID: https://orcid.org/0000-0001-5430-8957)
- Nancy Chan (ORCID: https://orcid.org/0000-0002-0047-5108)
- Virginie Adam (ORCID: https://orcid.org/0000-0002-5271-7287)
- Kristin M. Conway (ORCID: https://orcid.org/0000-0001-8633-966X)
Institutions
- University of Iowa (US)
- Harvard University (US)
- Royal College of Surgeons in Ireland (IE)
- Emory University (US)
- Duke University (US)
- University of Milan (IT)
- Institut Jules Bordet (BE)
- Yale Cancer Center (US)
- Breast International Group (BE)
- NYU Langone Health (US)
- Breast Cancer Care (GB)
- Cancer Trials Ireland (IE)
- Dana-Farber Cancer Institute (US)
- Duke Institute for Health Innovation (US)
- Duke Medical Center (US)
- European Institute of Oncology (IT)
- University of Pennsylvania (US)
- Ludwig-Maximilians-Universität München (DE)
Publication Details
- Journal
- npj Breast Cancer
- Published
- 2025-11-13
- DOI
- https://doi.org/10.1038/s41523-025-00835-7
- Citations
- 1
- Primary Topic
- Breast Cancer Treatment Studies
- Type
- article
- Field-Weighted Citation Impact
- 0.94
Funders
- Breast Cancer Research Foundation