title: Locoregional recurrence in patients with HER2 positive breast cancer.
abstract: Literature shows that HER2/neu positive breast cancer cells are more sensitive to radiation-induced apoptosis by targeting the epidermal growth factor receptor family tyrosine kinase. We selected 466 patients with pT1-2 HER2/neu positive tumors who received adjuvant trastuzumab for primary invasive breast cancer. Patients were divided into three groups [Quadrantectomy followed by conventional radiotherapy vs Quadrantectomy followed by Intra-operative radiotherapy with electrons vs Mastectomy without radiotherapy]. After a median follow-up of 52 months, the 5-year cumulative incidence of locoregional recurrence (LRR) was 1.9%, 11.5% and 5.0% respectively (p < 0.01). At the multivariate analysis, extensive perivascular invasion, Luminal B HER2/Progesterone Receptor (PgR) negative status and Quadrantectomy followed by Intra-operative radiotherapy with electrons have significantly increased the risk of LRR. Our results suggest that HER2/neu positive breast cancer might have better outcomes when treated simultaneously with external radiotherapy and trastuzumab. Moreover, we underline the importance of PgR and further new stratification of risk among luminal subtypes.
authors: Division of Medical Oncology, Department of Medicine, European Institute of Oncology, Milan, Italy.
authors: Janaina
authors: J
authors: Brollo
authors: Maximiliano Cassilha
authors: MC
authors: Kneubil
authors: Edoardo
authors: E
authors: Botteri
authors: Nicole
authors: N
authors: Rotmensz
authors: Bruno Achutti
authors: BA
authors: Duso
authors: Luca
authors: L
authors: Fumagalli
authors: Marzia Adelia
authors: MA
authors: Locatelli
authors: Carmen
authors: C
authors: Criscitiello
authors: Visnu
authors: V
authors: Lohsiriwat
authors: Aron
authors: A
authors: Goldhirsch
authors: Maria Cristina
authors: MC
authors: Leonardi
authors: Roberto
authors: R
authors: Orecchia
authors: Giuseppe
authors: G
authors: Curigliano
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000737:chemistry / Q000628:therapy*; D002277:Carcinoma / Q000737:chemistry / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000737:chemistry; D018714:Radiotherapy, Adjuvant / Q000379:methods; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012189:Retrospective Studies; D000068878:Trastuzumab; D055815:Young Adult
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D019394:Ki-67 Antigen; D018719:Erb-b2 Receptor Tyrosine Kinases; D011980:Receptors, Progesterone; D000068878:Trastuzumab; C508053:ERBB2 protein, human
keywords: Breast cancer; HER2/neu; Locoregional recurrence; Radiation therapy; Trastuzumab