PROGNOSTIC SIGNIFICANCE OF c‐erbB‐2 ONCOGENE IN AXILLARY NODE‐NEGATIVE BREAST CANCER

Abstract

Background: With the advent of screening mammography more breast cancer will be detected at an earlier stage, apparently confined to the breast with no nodal involvement. However, 30% of these will recur due to micrometastases present at the time of diagnosis. Chemotherapy and tamoxifen have been shown to improve disease‐free survival in axillary node‐negative patients but not overall survival. In the search for a useful predictor of breast cancer recurrence the relationship between c‐erbB‐2 expression and recurrence and survival was examined. Methods: Eighty‐eight axillary node‐negative breast cancer patients were followed up for at least 5 years. Results: There was a significant relationship between c‐erbB‐2 expression and both tumour recurrence (P < 0.001) and poorer survival (P = 0.003). In a Cox multiple regression analysis, c‐erbB‐2 staining remained the only significant prognostic variable for recurrence (P= 0.002) and survival (P = 0.032). Tumour recurrence in c‐erbB‐2‐positive cases tended to occur early in the course of follow up and was associated with poorer survival. Conclusion: C‐erbB‐2 was found to be a useful prognostic indicator for early recurrence and poorer survival in axillary node‐negative breast cancer patients.

Importance of Missed Axillary Micrometastases in Breast Cancer Patients

“…In fact, as the pathology technician cuts to reach the central cross‐section of the node, approximately half of the material is lost down the cryostat. When lymph nodes are subjected to more intense evaluation, 9.4–33% of patients are found to have metastases previously undetected by these standard pathologic methods (3–25). Several techniques have been shown to increase the detection of axillary lymph node metastases.…”

c-erbB-2/HER2/NEU Protein in Breast Cancer - Current State of Knowledge

“…Many authors underlined the independent character of this prognostic factor (24,35,45). The majority of authors observed that the presence of overexpression of cerbB-2 protein in breast cancer cells is associated with poorer overall survival (31, 35,36,38,44,45,49). Many authors underlined its independent character (35,36,38,44,45,49).…”

“…Some authors observed that the prognostic effect of overexpression of c-erbB-2 is visible solely in patients with metastases in axillary lymph nodes (38); they claimed that there is no association between overexpression of c-erbB-2 and prognosis in patients without metastases in axillary lymph nodes (38). Conversely, others found that the prognostic effect of c-erbB-2 overexpression is also present in patients without axillary lymph node metastases (48,49). There were also authors who did not find association between the overexpression of c-erbB-2 and disease-free survival or overall survival (46).…”

“…The majority of authors observed that the presence of overexpression of cerbB-2 protein in breast cancer cells is associated with poorer overall survival (31, 35,36,38,44,45,49). Many authors underlined its independent character (35,36,38,44,45,49). Some authors observed that the prognostic effect of overexpression of c-erbB-2 is visible solely in patients with metastases in axillary lymph nodes (38); they claimed that there is no association between overexpression of c-erbB-2 and prognosis in patients without metastases in axillary lymph nodes (38).…”

Analysis of HER2 gene amplification using Differential PCR in breast cancer patients of Isfahan Province

“…HER2 gene frequently undergoes amplification and overexpression in breast cancer cases (4,5), leading to disease recurrence and reduced overall survival (6)(7)(8)(9). Human breast tumors have different behaviors among HER2 gene copy number ranges of 1, 2-5, 5-20, and >20.…”