title: HER2 overexpression a major risk factor for recurrence in pT1a-bN0M0 breast cancer: results from a French regional cohort.
abstract: The management of pT1a-bN0M0 breast cancer remains an area of controversy. Data from 714 patients classified as having pT1a-bN0M0 breast cancer and treated, from 1999 to 2004 in the Languedoc-Roussillon France, were analyzed. The human epidermal growth factor receptor 2 (HER2) status analyses were centralized. The objective of this study was to describe the prognosis of pT1a-bN0M0 breast cancer according to HER2 distribution and hormonal status. The median follow-up was 6.4 years. Ten-year overall survival was 94%. HER2 overexpression was observed in 6.1% of the patients. The 10-year prognosis of patients with HER2-positive tumors was worse than that of those with HER2-negative (disease-free survival 73% vs. 89%, P < 0.0001). Tumor size (T1a/T1b) was not a relevant prognostic factor. The co-expression of HER2 with hormonal receptors (HR) was associated with high recurrence at 10 years. In both univariate and multivariate analyses, the most relevant prognostic factor for this population was HER2 amplification. In multivariate analysis, patients with HER2-positive tumors had higher risk of mortality (HR, 3.89; 95% CI, 1.58-9.56). In pT1a-bN0M0 breast cancers, HER2 amplification or overexpression is a risk factor for recurrence. In HER2-positive breast cancers, HR expression is associated with a poor prognosis despite the hormone therapy. For this population, a personalized management may be required.
authors.affiliation: Montpellier Cancer Institute/Val d'Aurelle, Montpellier, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Rouanet
authors.forename: Pascal
authors.initials: P
authors.lastname: Roger
authors.forename: Emilie
authors.initials: E
authors.lastname: Rousseau
authors.forename: Severine
authors.initials: S
authors.lastname: Thibault
authors.forename: Gilles
authors.initials: G
authors.lastname: Romieu
authors.forename: Andre
authors.initials: A
authors.lastname: Mathieu
authors.forename: Jacques
authors.initials: J
authors.lastname: Cretin
authors.forename: Gilbert
authors.initials: G
authors.lastname: Barneon
authors.forename: Mireille
authors.initials: M
authors.lastname: Granier
authors.forename: Aurelie
authors.initials: A
authors.lastname: Maran-Gonzalez
authors.forename: Jean P
authors.initials: JP
authors.lastname: Daures
authors.forename: Florence
authors.initials: F
authors.lastname: Boissiere
authors.forename: Frederic
authors.initials: F
authors.lastname: Bibeau
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000235:genetics* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005602:France; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics*; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human
keywords: HER-2 positive tumors; small breast carcinoma