title: HER2 amplification in recurrent breast cancer following breast-conserving therapy correlates with distant metastasis and poor survival.
abstract: The authors analyzed the HER2 status in early-stage nonrecurrent and recurrent breast cancer groups following breast-conserving treatment. Retrospective analyses of a group of 36 invasive early breast cancer (IBC) patients who developed a local recurrence as a first event and of a random control group of 69 IBC patients were made. HER2 status was assessed by the HercepTest and fluorescence in situ hybridization. The Kaplan-Meier proportional log-rank test was used to study the impact of the biological factors on the metastasis-free interval (MFI) and the overall survival (OS). The Cox proportional hazards model, using stepwise selection was performed to identify the independent predictors of poor outcome. The median time of follow-up was 156 months (range: 22-230) for the nonrecurrent group of patients and 119 months (range: 36-228) for the recurrent group. No significant differences between either group were observed in terms of either patient or tumor characteristics, or of HER2 expression. However, a higher proportion of HER2 amplified cases were found in the recurrent group, in contrast to a higher proportion of hormonal receptor positive cases in the nonrecurrent group. After univariate and multivariate analyses, HER2 amplification was found to be an independent predictive factor for distant metastasis (HR = 10.75; p = 0.00008) and for survival (HR = 4.22; p = 0.004). In conclusion, HER2 amplification constitutes an independent poor prognostic factor for the MFI and OS in patients with recurrent breast cancer. The clinical implications are discussed.
authors.affiliation: Unit of Molecular Biology, Fundación Instituto Valenciano de Oncología, Valencia, Spain.
authors.forename: José A
authors.initials: JA
authors.lastname: López-Guerrero
authors.forename: Antonio
authors.initials: A
authors.lastname: Llombart-Cussac
authors.forename: Rosa
authors.initials: R
authors.lastname: Noguera
authors.forename: Samuel
authors.initials: S
authors.lastname: Navarro
authors.forename: Antonio
authors.initials: A
authors.lastname: Pellin
authors.forename: Sergio
authors.initials: S
authors.lastname: Almenar
authors.forename: Carlos
authors.initials: C
authors.lastname: Vazquez-Alvadalejo
authors.forename: Antonio
authors.initials: A
authors.lastname: Llombart-Bosch
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics* / Q000473:pathology / Q000601:surgery*; D005260:Female; D005784:Gene Amplification; D018734:Genes, erbB-2; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis