title: EGFR overexpression relates to triple negative profile and poor prognosis in breast cancer patients in Tunisia.
abstract: BACKGROUND
  The prognosis of breast carcinoma is related to a large variety of clinical and pathological factors. Currently, only oestrogen (ER) and progesterone (PR) receptors and human epidermal growth factor receptor 2 (HER2) are used in routine pathological assessment as biomarkers. The aim of this study was to evaluate the prognostic impact of epidermal growth factor receptor (EGFR) expression individually and in combination to classical biomarkers (HER2, ER, and PR), and its relation to tumors with triple negative profile in Tunisian breast carcinoma.
  
  
  METHODS
  Immunohistochemistry was used to estimate the rate expression of these receptors. Univariate and multivariate analyses were used to explore the prognostic significance of EGFR in this study.
  
  
  RESULTS
  The expression rate of EGFR was 28.6%. EGFR expression was inversely correlated to that of ER (P < 0.001). Significant correlations between the expression of EGFR and the high histological Scarff-Bloom-Richardson (SBR) grade (P = 0.038) and also with tumors size (P = 0.041) were observed. The triple negative profile (TN: ER-/PR-/HER2-) was present in 17.3% of cases. EGFR overexpression was positively associated with this clinical aggressive profile (P < 0.001). Survival analysis showed that EGFR expression was associated with poor survival of patients (P = 0.004). In multivariate analysis, EGFR expression (P = 0.035) was found to be independent prognostic factors (significantly correlated to survival).
  
  
  CONCLUSIONS
  EGFR overexpression was observed in 28.6% of Tunisian breast carcinoma, associated with unfavorable prognosis and with triple negative tumors. Systemically evaluation of EGFR in breast carcinoma could benefit especially to TN subgroup from EGFR targeting agents.
authors.affiliation: Unit of Bioinformatics, Biostatistics and Signalling, Centre of Biotechnology of Sfax, Sfax University, Sfax, Tunisia. kallel1imen@yahoo.fr
authors.forename: Imen
authors.initials: I
authors.lastname: Kallel
authors.forename: Abdelmajid
authors.initials: A
authors.lastname: Khabir
authors.forename: Noureddine
authors.initials: N
authors.lastname: Boujelbene
authors.forename: Raoudha
authors.initials: R
authors.lastname: Abdennadher
authors.forename: Jamel
authors.initials: J
authors.lastname: Daoud
authors.forename: Mounir
authors.initials: M
authors.lastname: Frikha
authors.forename: Sami
authors.initials: S
authors.lastname: Aifa
authors.forename: Tahya
authors.initials: T
authors.lastname: Sallemi-Boudawara
authors.forename: Ahmed
authors.initials: A
authors.lastname: Rebaï
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000378:metabolism*; D066246:ErbB Receptors / Q000378:metabolism*; D005260:Female; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000096:biosynthesis; D011960:Receptors, Estrogen / Q000096:biosynthesis; D011980:Receptors, Progesterone / Q000096:biosynthesis; D016896:Treatment Outcome; D014416:Tunisia
chemical_list: D066246:ErbB Receptors; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone