Comparison of proliferation and other prognostic biomarkers in lymph node negative primary invasive breast cancer in Spain and Norway
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Purpose:It is to evaluate patients from Spain and Norway with lymph node (LN)-negative cancer of the Luminal A, Luminal B and Basal-like type, analyzing them through prognostic and predictive factors to determine if there are differences and if they are related to the survival variations. Patients and methods:A retrospective non-intervention study, analysis of MAI, TILs and other prognosticators in 406 patients (median follow-up 162 months; range 1 to 287 months), without neo-adjuvant therapy. Results:161 patients from Spain and 245 patients from Norway were evaluated, with an average age of 59.7 and 55.7, respectively. Distant metastases occurred in 5 Spanish patients (3%) and 21 (13%) died of metastases. Among the Norwegian patients, distant metastases occurred in 18 patients (6%) and 14 (5%) died of the metastases. It was shown that ER negativity (36.8%) and PR negativity (51.5%) were higher in Spanish dataset than in the Norwegian dataset 17.9% and 41.6%. It was also shown that the dataset in Spain contained more grade 3 (53.5%) than the Norwegian dataset (23.8%) and larger tumors in Spain (%) and (%) in Norway. MAI10 showed to be a strong prognostic factor for the Norwegian patients (p=0.005). Even though prognostic markers showed a worse prognosis for the Spanish patients, the distant metastases free survival was equal for both datasets (p>0.05).TILs were assessable for 131 Spanish cases, 74 patients with low TILs (<15) were associated with ER-positive and 12 patients with high TILs (>15) were associated with ER-negative. The expression analysis of miR-18a and miR-18b were assessable for 18 of the Spanish cases, a high expression of these were associated to ER-negative and high TILs levels. Conclusions: The 10-year survival evaluation of MAI10 is an important prognostic factor in the Norwegian patients. The survival of patients in Spain may be associated with their eating habits. References are made to studies on the topic, but it is necessary to deepen this research on the effect of diet and lifestyle on the survival of cancer patients. Regarding the miR-18a and miR-18b expression, a further analysis in larger patient cohorts is needed to statistically validate its expression and its value as a prognosticator and treatment response. Please notice that there were issues with the reference list. There is a possible mismatch and references that did not come in the last draft. If there is a possibility to fix it, please let me know. Truly sorry for the problems.