title: Tissue expression and serum levels of the oncoprotein HER-2/neu in 157 primary breast tumours.
abstract: BACKGROUND
  We studied HER-2 expression in paired serum and tissue samples, in 157 selected cases from 701 consecutive primary breast cancer patients with pre-treatment HER-2 extracellular domain (ECD) > or = 10 ng/ml, or < 10 ng/ml but showing a HER-2 ECD lead time before first metastasis.
  
  
  METHODS
  HER-2 ECD was measured by the Immuno 1 automated ELISA (Bayer). Tumour tissue was analysed by immunohistochemistry (IHC) with Dako A 0485 and CB 11 antibodies and scored with the Dako scoring system.
  
  
  RESULTS
  Mean HER-2 ECD was 12.48+/-7.08 ng/ml and 21/157 (13.4%) sera were > or = 15 ng/ml (cut-off). Forty tumours (25.48%) showed both invasive and intraductal components, 3 (1.91%) were pure in situ carcinomas and 114 (72.61%) were pure invasive tumours. Elevated HER-2 ECD concentration was related only to pT (p=0.0008), histological grade (p=0.0465), presence of comedonecrosis (p=0.0123) or comedo-type carcinoma (p=0.041) and was unrelated to the presence of an intraductal component. HER-2 ECD was > or = 15 ng/ml in 48% of Dako 3+ and 60% of CB 11 2+ and 3+ tumours. By logistic regression analysis, the significant parameters associated with HER-2 ECD concentration were pT (p=0.0038) and Dako 3+ scores (p=0.0005). In Dako 3+ or CB 11 2+3+ tumours, elevated mean HER-2 ECD concentrations were observed only when pT exceeded 28-30 mm (p=0.0062 and p=0.0036, respectively).
  
  
  CONCLUSIONS
  In breast tumours, a threshold in size and HER-2 overexpression is necessary to observe elevated concentrations of HER-2 ECD at diagnosis. This information may be useful when the primary tumour is not available for IHC.
authors.affiliation: Service de Pathologie, Centre René-Huguenin De Lutte Contre Le Cancer, 92210 Saint-Cloud, France.
authors.forename: C
authors.initials: C
authors.lastname: Pallud
authors.forename: J M
authors.initials: JM
authors.lastname: Guinebretiere
authors.forename: S
authors.initials: S
authors.lastname: Guepratte
authors.forename: K
authors.initials: K
authors.lastname: Hacene
authors.forename: R
authors.initials: R
authors.lastname: Neumann
authors.forename: W
authors.initials: W
authors.lastname: Carney
authors.forename: M F
authors.initials: MF
authors.lastname: Pichon
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000097:blood / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000097:blood* / Q000378:metabolism*; D012044:Regression Analysis
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases