HER-2/neu overexpression in invasive ductal breast cancer: An association with other prognostic and predictive factors

Abstract

Background: HER-2/neu is a proto-oncogene that is amplified/overexpressed in 15 to 30% of invasive breast cancers. The purpose of this study was to determine if any relationship exist between HER-2/neu protein overexpression and estrogen receptor (ER), progesterone receptor (PR), grade, size, and lymph node status in female breast cancer. Methods: A total of 100 cases of invasive ductal breast cancer were included in this study. The hormone receptors and HER-2/neu were studied immunohistochemically (IHC). Using the HER-2/neu DAKO scoring system, scores of 0, 1+ and 2+ were defined as negative and 3+ as positive. Results: HER-2/neu protein overexpression was seen in 20 (20%) of cases. HER-2/neu protein overexpression was present in 4 of 52 T1 lesions (8%), in 11 of 37 T2 lesions (30%), in 3 of 6 T3 lesions (50%), and in 2 of 5 T4 lesions (40%), (p<0.05). Protein overexpression was seen in 7 of 17 grade III tumors (41%), and 13 of 61 grade II tumors (21%). Overexpression was not detected in grade I tumors (p<0.01). Of the 20 Her-2/neu positive cases, ER- and PR-negative status was detected in 60% and 70%, respectively. Conclusion: Statistically significant correlation was found between HER-2/neu protein overexpression and large tumor size, high histological grade, and ER-, PR-negativity. There was no correlation with lymphonodal status

Study of ER, PR & HER-2/NEU reactivity pattern in the patient of Breast Cancer in northern part of india

“…This group appeared to represent an aggressive form of breast cancer, presenting at a younger age with large tumor size. Despite the great variation in levels of HER-2/neu positivity, nearly all investigators report a negative relationship between HER-2/neu status and steroid receptors levels [6,7,8,9] This inverse association has been linked to the fact that estrogens and its receptor are required to suppress HER-2. This leads to lower or absent hormone receptors in women with HER-2/neu positive breast cancers.…”

Large-format histology in diagnosing breast carcinoma

“…Key prognostic parameters are tumour size, histological grade, histological type, lymph node status, lymphovascular invasion, and presence or absence of distant metastases [1,2]. In addition, a few next-generation prognostic parameters have been introduced into routine practice, of which the status of oestrogen and progesterone receptor (ER and PR), human epidermal growth factor receptor 2 (HER2/neu), and proliferation of cancer cells are the most prominent [3,4]. Whereas steroid receptors, HER2 status, and proliferative activity are the major parameters for planning oncological therapy, breast cancer subgross morphological parameters such as tumour size, disease extent, and lesion distribution are essential for planning tailor-made surgery and radiation therapy [5][6][7][8][9].…”

Study on Estrogen Receptor, Progesterone Receptor and HER-2/ neu Expression Pattern by Immunohistochemistry in 87 cases of Invasive Breast Cancer

“…The over expression of HER-2/neu protein and amplification of the HER-2/neu gene is also associated with poor prognostic tumour characteristics such as high histological grade, high proliferative index, negative or lower ER expression and p53 mutation. HER-2/neu status along with ER/PR status are considered together to give any adjuvant systemic therapy 6 . HER-2/neu over expression has therapeutic implication in invasive breast cancer.…”

“…Other method is Fluorescence in situ hybridization (FISH) used to assess gene amplification. FISH should be reserved for weakly positive (2+) cases stained by IHC 6 .…”