title: HER-2/neu overexpression as a predictor for the transition from in situ to invasive breast cancer.
abstract: The clinical implications of HER-2/neu (HER2) expression in ductal carcinoma in situ (DCIS) lesions have yet to be clearly elucidated; this despite the more frequent expression of HER2 in high-grade DCIS lesions compared with invasive cancers. We hypothesized that HER2 overexpression in DCIS is associated with more rapid progression to invasive disease. Immunohistochemical staining for estrogen receptor, progesterone receptor, and HER2 was done on DCIS specimens. Univariate analysis and a multivariate logistic regression were done to determine whether estrogen receptor, progesterone receptor, or HER2 status, comedo necrosis, nuclear grade, lesion size, or patient age predicted the presence of associated invasive disease in patients with DCIS. Invasive foci were found in association with HER2 overexpressing DCIS at a higher frequency than with DCIS that did not overexpress HER2. Although high nuclear grade, large lesion size, and HER2 overexpression were all associated with the presence of invasive disease on univariate analysis, HER2 was the only significant predictor for the presence of invasive disease after multivariate adjustment (odds ratio, 6.4; P = 0.01). These data indicate that HER2 overexpression in DCIS lesions predicts the presence of invasive foci in patients with DCIS and suggest that targeting of HER2 in an early disease setting may forestall or prevent disease progression.
authors.affiliation: Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Roses
authors.forename: E Carter
authors.initials: EC
authors.lastname: Paulson
authors.forename: Anupama
authors.initials: A
authors.lastname: Sharma
authors.forename: Jeanne E
authors.initials: JE
authors.lastname: Schueller
authors.forename: Harvey
authors.initials: H
authors.lastname: Nisenbaum
authors.forename: Susan
authors.initials: S
authors.lastname: Weinstein
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Fox
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Zhang
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Czerniecki
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D001706:Biopsy; D001940:Breast / Q000378:metabolism* / Q000473:pathology; D001943:Breast Neoplasms / Q000378:metabolism* / Q000473:pathology; D002278:Carcinoma in Situ / Q000378:metabolism* / Q000473:pathology; D016009:Chi-Square Distribution; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone