title: The significance of HER-2 amplification and the size and type of pathological unicentric, initially operable clinical stage I and IIA/IIB breast cancer, in determining the treatment strategy.
abstract: OBJECTIVE
  In order to determine the initial treatment strategies for primary operable unicentric breast cancer, the possible relationships of the amplification of human epidermal growth-factor receptor-2 (HER-2), with age, menstrual status, tumor pathological size (pT), histopathological tumor type (HP) and kind of surgical treatment were studied.
  
  
  METHODS
  Analysed were 301 patients treated initially by surgery in the period 2006-2009. HP tumor type, pT and HER-2 status (using firstly immunohistochemistry and then chromogenic in situ hybridization/CISH) were determined. The patients were divided into 2 subgroups according to the presence (CISH+)/absence (CISH-) of HER-2 amplification.
  
  
  RESULTS
  Data on pT and HER-2 analyses were available for 293/301 (98.3%) patients with ductal (DC) and lobular carcinoma (LC). Amplification of HER-2 was found in 66 (21.9%) patients. No significant difference between the two subgroups regarding age (p=0.08), menstrual status (p>0.05) and kind of operation (p>0.05) was found. HP showed statistically significant difference between DC (55; 83.3%) and LC (11; 16.7%) patients with HER-2 amplification (p<0.01). Further HP analysis of the type of cancer within the pT category as a subgroup showed significantly higher frequency of HER-2 amplification in DC patients for pT1 (p<0.01) and in pT2 + pT3pN0 (p<0.05) compared with patients with LC.
  
  
  CONCLUSIONS
  This study showed a significantly higher incidence of HER-2 amplification in DC tumors, especially in pT1 and pT2, than in LC, which may influence the options in treatment strategies in primary unicentric operable DC type of breast cancer.
authors.affiliation: Clinic of Oncological Surgery, Institute of Oncology and Radiology of Serbia, Belgrade, Serbia. miletic.nesa@gmail.com
authors.forename: N
authors.initials: N
authors.lastname: Miletic
authors.forename: I
authors.initials: I
authors.lastname: Golubicic
authors.forename: D
authors.initials: D
authors.lastname: Gavrilovic
authors.forename: R
authors.initials: R
authors.lastname: Dzodic
authors.forename: T
authors.initials: T
authors.lastname: Pavlovic
authors.forename: M
authors.initials: M
authors.lastname: Nikitovic
authors.forename: D
authors.initials: D
authors.lastname: Stojiljkovic
authors.forename: A
authors.initials: A
authors.lastname: Karaferic
authors.forename: G
authors.initials: G
authors.lastname: Pupic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000235:genetics / Q000473:pathology / Q000628:therapy*; D005260:Female; D005784:Gene Amplification; D006801:Humans; D017403:In Situ Hybridization; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics*
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human