HER-2 expression and cell proliferation: prognostic markers in patients with node-negative breast cancer.
OBJECTIVE
We analyzed the clinical relevance of HER-2 expression, widely investigated in breast cancer but with contradictory results, in the largest case series of node-negative breast cancer patients investigated to date.


METHODS
The pure prognostic value of HER-2 expression was investigated in 529 patients treated with locoregional therapy alone until early relapse. Proliferative activity was evaluated as [3H]thymidine labeling index and HER-2 expression by immunohistochemistry. All biologic determinations were conducted within the context of an intra- and interlaboratory National Quality Control Program.


RESULTS
HER-2 expression was not related to relapse-free survival in the overall series but was a significant discriminant of prognosis in the subgroup of patients with rapidly proliferating tumors. Six-year rate of relapse was 40% for patients with highly (> or =30%) positive tumors and 26% for those with weakly HER-2-expressing tumors (P =.039).


CONCLUSIONS
HER-2 expression in association with proliferative activity identifies a subgroup of node-negative breast cancer patients with the worst prognosis, who are candidates for specific intensive adjuvant therapy.
Volpi
Annalisa
A
Dept of Medical Oncology, Pierantoni Hospital, via Forlanini 34, 47100 Forlì, Italy. a.volpi@ausl.fo.it.
Nanni
Oriana
O
De Paola
Franca
F
Granato
Anna Maria
AM
Mangia
Annita
A
Monti
Franco
F
Schittulli
Francesco
F
De Lena
Mario
M
Scarpi
Emanuela
E
Rosetti
Paola
P
Monti
Manlio
M
Gianni
Lorenzo
L
Amadori
Dino
D
Paradiso
Angelo
A
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D014408:Biomarkers, Tumor / Q000032:analysis; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000235:genetics* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002455:Cell Division / Q000502:physiology*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D046508:Culture Techniques; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D008940:Mitotic Index; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics*; D012044:Regression Analysis; D012680:Sensitivity and Specificity; D015996:Survival Rate
D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases