Table 2.

Clinicopathologic characteristics of the 6 patients with ER-positive, HER2-negative, node-negative breast carcinoma of recurrence score <18 who developed distant metastasis

Patients	#1	#2	#3	#4	#5	#6
Age at diagnosis (years)	50	54	37	71	38	39
Menopausal status	Pre	Pre	Pre	Post	Pre	Pre
Family history of breast/ovarian cancer	No	Yes	No	No	No	Yes
Personal history of breast carcinoma	No	Ipsilateral DCIS, 8 years prior	No	Ipsilateral DCIS, 13 years prior	No	No
Tumor type	ILC, classical and pleo-morphic	IDC	IDC	IDC a	IDC with focal micro-papillary features	IDC
Tumor size (cm)	2.1	1.3	2.7	2.3	1.6	2.1
Tumor Grade	2	2	2	2	2	3
Multi-focality	Yes	Yes	Yes	Yes	No	No
LVI	No	No	No	No	Yes	No
ER (%)	90	95	95	95	95	95
PR (%)	30	5	85	75	75	95
Oncotype DX RS	5	12	12	13	14	17
ESR1 expression	10.2	9.3	10.8	10.7	9.2	9.5
Surgery	BTM	TM	BTM	BCS	BCS	BTM
Radiation Tx	No	No	No	Yes	Yes	No
Endocrine Tx	Tamoxifen × 5 years, then BSO, followed by Letrozole	Tamoxifen	Tamoxifen	Arimidex	Nob	Tamoxifen
ChemoTx	No	No	CMF	No	No	No
Time interval to metastasis (months)	58	41	25	20	48	12
Site of metastasis	Bone	Lung, liver, brain, bone	Lung	Bone, liver, brain, lung	Bone, liver	Bone
Follow-up (months)	72	53	59	64	71	42
Survival	AWD	AWD	AWD	DOD	AWD	AWD

Abbreviations: RS, recurrence score; ILC, invasive lobular carcinoma; IDC, invasive ductal carcinoma; LVI, lymphovascular invasion; BTM, bilateral total mastectomy; TM, total mastectomy; BCS, breast conserving surgery; Tx, therapy; BSO, bilateral salpingo-oophorectomy; CMF, cyclofosphamide, metotrexate and 5-fluorouracil. AWD, alive with disease; DOD, died of disease.

^aThis patient also had two foci of ILC, measuring 0.6 cm and 0.2 cm respectively.

^bThis patient declined hormonal treatment.