TY - JOUR
T1 - Her-2 prognostic value in very early-stage breast cancer
T2 - A single-institution retrospective analysis
AU - Sanpaolo, Pietro
AU - Barbieri, Viviana
AU - Pedicini, Piernicola
AU - Fusco, Vincenzo
PY - 2012/6
Y1 - 2012/6
N2 - To evaluate overall survival, distant metastases-free survival and local relapse-free survival rates in a subgroup of patients affected by breast cancer expressing Her-2/neu. Data of 195 women affected by very early-stage breast cancer (pT1a-b pN0) who underwent whole breast radiotherapy after conservative surgery with or without chemotherapy and/or hormone therapy between January 2000 and December 2006 were evaluated. Chi-square test was used to compare the distribution of variables (age, tumour histology, oestrogens and progesterone receptors, tumour grading and adjuvant chemotherapy) between Her-2-positive and Her-2-negative patients. Survival rates were analysed with Kaplan-Meier curves; impact of variables on poor outcome was evaluated with Cox regression method. Median follow-up time was 63.5 months (range 13.8-113.6). Her-2/neu-positive patients (32/16.4%), compared to Her-2/neu-negative patients (163/83.6%), were younger (P = 0.0001), were affected by ductal infiltrating carcinoma (P = 0.039), had negative oestrogens receptors (P = 0.0001) and were not treated with chemotherapy (P = 0.001). Her-2-positive patients had lower overall survival (P = 0.00001) and lower distant metastases-free survival (P = 0.00001) compared to Her-2-negative patients, but no difference in local relapse-free survival was found between the two groups (P = 0.28). After multivariate analysis, Her-2-positive status was a prognostic factor for overall survival (P = 0.00001) and for distant metastases-free survival (P = 0.0001), but not for local relapse-free survival (P = 0.97). Her-2-positive patients have lower overall survival and distant metastasesfree survival when compared to Her-2 negative patients but similar local relapse-free survival rates. These patients could be treated with conservative surgery, if feasible, but should receive more aggressive and tailored systemic adjuvant therapies.
AB - To evaluate overall survival, distant metastases-free survival and local relapse-free survival rates in a subgroup of patients affected by breast cancer expressing Her-2/neu. Data of 195 women affected by very early-stage breast cancer (pT1a-b pN0) who underwent whole breast radiotherapy after conservative surgery with or without chemotherapy and/or hormone therapy between January 2000 and December 2006 were evaluated. Chi-square test was used to compare the distribution of variables (age, tumour histology, oestrogens and progesterone receptors, tumour grading and adjuvant chemotherapy) between Her-2-positive and Her-2-negative patients. Survival rates were analysed with Kaplan-Meier curves; impact of variables on poor outcome was evaluated with Cox regression method. Median follow-up time was 63.5 months (range 13.8-113.6). Her-2/neu-positive patients (32/16.4%), compared to Her-2/neu-negative patients (163/83.6%), were younger (P = 0.0001), were affected by ductal infiltrating carcinoma (P = 0.039), had negative oestrogens receptors (P = 0.0001) and were not treated with chemotherapy (P = 0.001). Her-2-positive patients had lower overall survival (P = 0.00001) and lower distant metastases-free survival (P = 0.00001) compared to Her-2-negative patients, but no difference in local relapse-free survival was found between the two groups (P = 0.28). After multivariate analysis, Her-2-positive status was a prognostic factor for overall survival (P = 0.00001) and for distant metastases-free survival (P = 0.0001), but not for local relapse-free survival (P = 0.97). Her-2-positive patients have lower overall survival and distant metastasesfree survival when compared to Her-2 negative patients but similar local relapse-free survival rates. These patients could be treated with conservative surgery, if feasible, but should receive more aggressive and tailored systemic adjuvant therapies.
KW - Conservative therapy
KW - Early-stage breast cancer
KW - Her-2/neu oncogene
KW - Radiation therapy
UR - http://www.scopus.com/inward/record.url?scp=84866268747&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84866268747&partnerID=8YFLogxK
U2 - 10.1007/s12032-011-9869-0
DO - 10.1007/s12032-011-9869-0
M3 - Article
C2 - 21359639
AN - SCOPUS:84866268747
VL - 29
SP - 459
EP - 465
JO - Medical Oncology
JF - Medical Oncology
SN - 1357-0560
IS - 2
ER -