title: The prognostic significance of pathological features in Her-2 overexpressing breast carcinomas: A single institution experience in southern Tunisia.
abstract: BACKGROUND
  Breast cancer is the most frequent malignant neoplasm affecting Tunisian women. It represents 25 to 35% of all female cancers. There is no published study about the features of Her-2 overexpressing breast carcinomas in North African women.
  
  
  OBJECTIVE
  The aim of this study is to assess the prognostic significance of pathological features in a cohort of a Her-2 overexpressing breast carcinoma originating from the region of south Tunisia.
  
  
  METHODS
  This study investigated a series of 100 patients followed from January 2006 to December 2011 for a Her-2 positive invasive breast carcinoma. Pathological features included in this study were: histological type, histological grade, tumor size, vascular invasion, perineural invasion, mitotic index, lymph nodes stage, positive lymph node capsular effraction, inflammatory infiltrates, nipple involvement and hormone receptors status.
  
  
  RESULTS
  Multivariate analysis showed that pT stage, pN stage, capsular effraction, vascular invasion, perineural invasion and Nipple involvement were independent prognostic factors for overall survival and disease free survival in patients free from distant metastasis at diagnosis. For patients with synchronous metastasis, there is no independent pathologic prognostic factor for survival.
  
  
  CONCLUSIONS
  Our study demonstrates that pathological features are important prognostic factors for non metastatic Her-2 overexpressing breast carcinomas. This supports the idea that HER2-positive disease is a heterogeneous entity. We believe that these findings reinforce the need to identify molecular predictors of benefit and resistance to anti-Her-2 based therapies.
authors.affiliation: Department of Pathology, CHU Habib Bourguiba, Sfax, Tunisia.
authors.forename: Slim
authors.initials: S
authors.lastname: Charfi
authors.affiliation: Department of Medical Oncology, CHU Habib Bourguiba, Sfax, Tunisia.
authors.forename: Nabil
authors.initials: N
authors.lastname: Toumi
authors.affiliation: Department of Medical Oncology, CHU Habib Bourguiba, Sfax, Tunisia.
authors.forename: Sana
authors.initials: S
authors.lastname: Triki
authors.affiliation: Department of Pathology, CHU Habib Bourguiba, Sfax, Tunisia.
authors.forename: Rim
authors.initials: R
authors.lastname: Kallel
authors.affiliation: Department of Gynecology, CHU Hedi Chaker, Sfax, Tunisia.
authors.forename: Sahbi
authors.initials: S
authors.lastname: Kebaïli
authors.affiliation: Department of Gynecology, CHU Hedi Chaker, Sfax, Tunisia.
authors.forename: Kais
authors.initials: K
authors.lastname: Chaabane
authors.affiliation: Department of Pathology, CHU Habib Bourguiba, Sfax, Tunisia.
authors.forename: Abdelmajid
authors.initials: A
authors.lastname: Khabir
authors.affiliation: Department of Radiotherapy, CHU Habib Bourguiba, Sfax, Tunisia.
authors.forename: Jamel
authors.initials: J
authors.lastname: Daoud
authors.affiliation: Department of Medical Oncology, CHU Habib Bourguiba, Sfax, Tunisia.
authors.forename: Mounir
authors.initials: M
authors.lastname: Frikha
authors.affiliation: Department of Pathology, CHU Habib Bourguiba, Sfax, Tunisia.
authors.forename: Tahya Sellami
authors.initials: TS
authors.lastname: Boudawara
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001808:Blood Vessels / Q000473:pathology; D001943:Breast Neoplasms / Q000737:chemistry* / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D002277:Carcinoma / Q000737:chemistry* / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009558:Nipples / Q000473:pathology; D010525:Peripheral Nerves / Q000473:pathology; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D015996:Survival Rate; D014416:Tunisia
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human
keywords: Breast cancer; HER-2; pathology; prognosis; survival