title: Prevalence of HER-2-positive invasive breast cancer: a systematic review from Iran.
abstract: BACKGROUND
  The HER-2/neu gene is altered in 15-20% of breast cancer patients. Immunohistochemistry (IHC) is considered to be the most cost-effective method for HER-2 detection in many countries. Approximately 8,000 new cases of breast cancer are observed annually in Iran. The aims of this study were to conduct a systematic review of the literature on the rate of HER-2-positive breast cancer diagnosed by IHC in Iran.
  
  
  METHODS
  A systematic search of the medical literature using the Medline/PubMed, ISI and SID databases revealed articles published in the English and Persian languages evaluating HER-2-positive breast cancer in Iran.
  
  
  RESULTS
  From 22 studies, 3,033 patients were evaluated, of whom 1,350 were diagnosed as HER-2-positive by IHC HER-2 testing. The mean percentage of HER-2-positive patients was 44.5%, which is higher than that recorded in international statistics. Results of this meta-analysis showed a significant heterogeneity between ratios. There was a statistically significant difference between the results of pre- and post implementation of 2007 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guideline. IHC HER-2 testing has been performed in Iran for over 10 years. Similar to many other countries, before establishment of an infrastructure for IHC diagnostic tests, HER-2 testing was routinely performed in Iran. Our study showed that the statistics reported from Iran varied widely; for instance, the rate of HER-2-positive cases varied from 23.3% to 81.0%.
  
  
  CONCLUSIONS
  Our results demonstrate that the lack of standardization and harmonization of this test have led to marked variations in breast cancer diagnosis in Iran.
authors: Genetics Research Center, Biostatistics Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran. ekeyhani1058@gmail.com
authors: Elahe
authors: E
authors: Keyhani
authors: Ahad
authors: A
authors: Muhammadnejad
authors: Masoud
authors: M
authors: Karimlou
mesh_terms: D001943:Breast Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000378:metabolism; D005260:Female; D006801:Humans; D007492:Iran / Q000453:epidemiology; D015995:Prevalence; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics / Q000378:metabolism*
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases