Originally published as JCO Early Release 10.1200/JCO.2007.15.8659 on November 10 2008

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Chia, S. Articles by Gelmon, K. Search for Related Content PubMed PubMed Citation Articles by Chia, S. Articles by Gelmon, K. Social Bookmarking                            What's this?

Human Epidermal Growth Factor Receptor 2 Overexpression As a Prognostic Factor in a Large Tissue Microarray Series of Node-Negative Breast Cancers

Stephen Chia, Brian Norris, Caroline Speers, Maggie Cheang, Blake Gilks, Allen M. Gown, David Huntsman, Ivo A. Olivotto, Torsten O. Nielsen, Karen Gelmon

From the Division of Medical Oncology, Breast Cancer Outcomes Unit, and Division of Radiation Oncology, British Columbia Cancer Agency; Genetic Pathology Evaluation Centre and Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada; and PhenoPath Laboratories, Seattle, WA

Corresponding author: Stephen Chia, MD, FRCP(C), Division of Medical Oncology, British Columbia Cancer Agency, University of British Columbia, 600 West 10th Ave, Vancouver, British Columbia, Canada, V5Z 4E6; e-mail: schia{at}bccancer.bc.ca

Purpose Human epidermal growth factor receptor 2 gene (HER2) is associated with a poorer outcome in node-positive breast cancer, but the results are conflicting in node-negative disease. This study assessed the prognostic impact of HER2 overexpression/amplification in a large series of node-negative breast cancers.

Patients and Methods A tissue microarray (TMA) series was constructed consisting of 4,444 invasive breast cancers diagnosed in British Columbia from 1986 to 1992. Within this series, 2,026 patients were node negative, of whom 70% did not receive adjuvant systemic therapy. The TMA series was assessed for estrogen receptor (ER) and HER2. Logistic regression modeling was used to estimate odds ratios at the 10-year follow-up.

Results HER2 was positive in 10.2% of the node-negative cohort. In this cohort, an inferior outcome was seen in patients with HER2-positive tumors compared with HER2-negative tumors for 10-year relapse-free survival (RFS; 65.9% v 75.5%, respectively; P = .01), distant RFS (71.2% v 81.8%, respectively; P = .004), and breast cancer–specific survival (BCSS; 75.5% v 86.3%, respectively; P = .001). A trend for a worse overall survival was also seen (P = .06). HER2 was an independent poor prognostic factor for RFS and BCSS at 10 years, with odds ratios of 1.71 (P = .01) and 2.03 (P = .003), respectively. The number of HER2-positive tumors that were 1 cm was small, but there was a trend for a worse outcome in T1b tumors.

Conclusion HER2 overexpression/amplification is correlated with a poorer outcome in node-negative breast cancer. Larger studies are needed to more clearly define the prognostic impact of HER2 in tumors 1 cm, particularly within the separate hormone receptor subgroups.

published online ahead of print at www.jco.org on November 10, 2008

Supported in part by grants from the Canadian Breast Cancer Research Alliance and Hoffmann LaRoche Inc.

Presented in part at the 29th San Antonio Breast Cancer Symposium, December 14-17, 2006, San Antonio, TX.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				A. Goldhirsch, J. N. Ingle, R. D. Gelber, A. S. Coates, B. Thurlimann, H.-J. Senn, and Panel members Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2009 Ann. Onc., June 17, 2009; (2009) mdp322v1. [Abstract] [Full Text] [PDF]