Background:The main molecular markers associated with breast cancer that classify patients into subtypes are estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2/neu) proteins. Based on ER, PR and HER2/neu analysis, tumors can be divided into the categories of basal-like, luminal, or HER2/neu positive. Objectives: The aim of this survey was to elucidate the efficacy of the prognostic significance of this classification scheme and to compare the clinicopathologic features and survival in the abovementioned subtypes defined by immunohistochemistry (IHC) in association with a variety of clinical and surgical parameters. Materials and Methods: For this prospective study, 163 women, ages 28-87, were registered consecutively. In each case in the database ER, PR, and HER2/neu levels were obtained through standard clinical testing, using IHC for ER and PR and the HercepTest for HER2/neu. Results: The statistical analysis of this sample showed that patients who were characterized as ER(-) and PR(-) had the worst survival, compared to HR( + ) women ( p < 0.001). In addition, there seemed to be strong relationship between a positive HER2/neu immunohistochemical profile and long-term survival ( p < 0.001). Furthermore, a higher proportion of triplenegative patients experienced distant recurrence and their mean time to disease progression was significantly shorter ( p < 0.001). Thus triple-negative classification was an independent predictor of disease aggressiveness or metastatic potential. Conclusions: Patients with triple-negative breast cancer have an increased likelihood of distant recurrence and death, compared to women with other types of breast cancer. Furthermore, the patterns of relapse in the two subgroups are completely different. ( J GYNECOL SURG 30:260)
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