title: Imaging features of HER2 overexpression in breast cancer: a systematic review and meta-analysis.
abstract: Breast cancer imaging phenotype is diverse and may relate to molecular alterations driving cancer behavior. We systematically reviewed and meta-analyzed relations between breast cancer imaging features and human epidermal growth factor receptor type 2 (HER2) overexpression as a marker of breast cancer aggressiveness. MEDLINE and EMBASE were searched for mammography, breast ultrasound, magnetic resonance imaging (MRI), and/or [(18)F]fluorodeoxyglucose positron emission tomography studies through February 2013. Of 68 imaging features that could be pooled (85 articles, 23,255 cancers; random-effects meta-analysis), 11 significantly related to HER2 overexpression. Results based on five or more studies and robustness in subgroup analyses were as follows: the presence of microcalcifications on mammography [pooled odds ratio (pOR), 3.14; 95% confidence interval (CI), 2.46-4.00] or ultrasound (mass-associated pOR, 2.95; 95% CI, 2.34-3.71), branching or fine linear microcalcifications (pOR, 2.11; 95% CI, 1.07-4.14) or extremely dense breasts on mammography (pOR, 1.37; 95% CI, 1.07-1.76), and washout (pOR, 1.57; 95% CI, 1.11-2.21) or fast initial kinetics (pOR, 2.60; 95% CI, 1.43-4.73) on MRI all increased the chance of HER2 overexpression. Maximum [(18)F]fluorodeoxyglucose standardized uptake value (SUVmax) was higher upon HER2 overexpression (pooled mean difference, +0.76; 95% CI, 0.10-1.42). These results show that several imaging features relate to HER2 overexpression, lending credibility to the hypothesis that imaging phenotype reflects cancer behavior. This implies prognostic relevance, which is especially relevant as imaging is readily available during diagnostic work-up.
authors.affiliation: Julius Center for Health Sciences and Primary Care; s.elias@umcutrecht.nl.
authors.forename: Sjoerd G
authors.initials: SG
authors.lastname: Elias
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht;
authors.forename: Arthur
authors.initials: A
authors.lastname: Adams
authors.affiliation: Radiology and Biomedical Imaging.
authors.forename: Dorota J
authors.initials: DJ
authors.lastname: Wisner
authors.affiliation: Surgery, and.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Esserman
authors.affiliation: Laboratory Medicine, University of California, San Francisco, San Francisco, California.
authors.forename: Laura J
authors.initials: LJ
authors.lastname: van't Veer
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht;
authors.forename: Willem P Th M
authors.initials: WP
authors.lastname: Mali
authors.affiliation: Department of Radiology, University Medical Center Utrecht, Utrecht; Department of Radiology, Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands; Departments of.
authors.forename: Kenneth G A
authors.initials: KG
authors.lastname: Gilhuijs
authors.affiliation: Radiology and Biomedical Imaging.
authors.forename: Nola M
authors.initials: NM
authors.lastname: Hylton
mesh_terms: D001943:Breast Neoplasms / Q000235:genetics / Q000473:pathology*; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D010641:Phenotype; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000096:biosynthesis*
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human