ASSOCIATION OF HER-2/neu OVEREXPRESSION WITH THE NUMBER OF INVOLVED AXILLARY LYMPH NODES IN HORMONE RECEPTOR POSITIVE BREAST CANCER PATIENTS
Tokatli Fusun1, Altaner Semsi2, Uzal Cem1, Ture Mevlut3,
Kocak Zafer1, Uygun Kazim4, Bilgi Selcuk2
1Department of Radiation Oncology, Faculty of Medicine, Trakya University, Edirne 22030, Turkey 2Department of Pathology, Faculty of Medicine, Trakya University, Edirne 22030, Turkey 3Department of Biostatistics, Faculty of Medicine, Trakya University, Edirne 22030, Turkey 4Department of Medical Oncology, Faculty of Medicine, Trakya University, Edirne 22030, Turkey
Abstract. Aim: To evaluate the prognostic significance of HER-2/neu overexpression in hormone receptor and axillary lymph node positive breast cancer patients treated in a single institution. Methods: Paraffin-embedded primary breast cancers from 40 patients with invasive ductal carcinoma were studied immunohistochemically. HER-2/neu staining was classified as negative (0, 1+), weak/moderate positive (2+), or moderate/strong positive (3+) and was assessed for effectiveness as a predictor of outcome in univariate and Cox model multivariate analyses. Results: 20% of patients were positive for HER-2/neu. Significant associations were observed between HER-2/neu and increasing number of involved nodes (p = 0.014), p53 positivity (p = 0.039), the presence of vascular invasion (p = 0.029) and metastases (p = 0.01). Multivariate analysis demonstrated that HER-2/neu overexpression (p = 0.016) and age (p = 0.005) were independent predictors for disease-free survival (DFS) where the number of involved nodes (p = 0.032) was shown to be independent predictor for overall survival. In the HER-2/neu positively stained tumors, significant number of patients developed distant metastases than the patients with HER-2/neu negatively stained tumors (87.5% vs 34.4%, p = 0.01). Conclusion: For node positive patients, HER-2/neu overexpression was a significant predictor of DFS.
Key Words:axillary lymph node involvement, breast cancer, HER-2/neu, prognosis.