BACKGROUND: The standardization of the HER2 score and recent changes in therapeutic modalities points to the need for a reevaluation of the role of HER2 in recently diagnosed breast carcinoma. PATIENTS AND METHODS: A multicenter, retrospective study of 1794 primary breast carcinomas diagnosed in Italy in 2000/2001 and scored in HER2 four categories according to immunohistochemistry was conducted. RESULTS: Ductal histotype, vascular invasion, grade, MIB1 positivity, estrogen and progesterone receptor expression differed significantly in HER2 3+ tumors compared with the other categories. HER2 2+ tumors almost showed values intermediate between those of the negative and the 3+ subgroups. The characteristics of HER2 1+ tumors were found to be in between those of HER2 0 and 2+ tumors. With a median follow-up of 54 months, HER2 3+ status was associated with higher relapse rates in node-positive and node-negative subgroups, while HER2 2+ only in node positive. Analysis of relapses according to type of therapy provided evidence of responsiveness of HER2-positive tumors to chemotherapy, especially taxanes. CONCLUSIONS: The present prognostic significance of HER2 is correlated to receptor expression level and points to the need to consider HER2 2+ and HER2 3+ tumors as distinct diseases with different outcomes and specific features.
Biology, prognosis and response to therapy of breast carcinomas according to HER2 score / S. Ménard, A. Balsari, E. Tagliabue, T. Camerini, P. Casalini, R. Bufalino, F. Castiglioni, M.L. Carcangiu, A. Gloghini, S. Scalone, P. Querzoli, M. Lunardi, A. Molino, M. Mandarà, M. Mottolese, F. Marandino, M. Venturini, C. Bighin, G. Cancello, E. Montagna, F. Perrone, A. De Matteis, A. Sapino, M. Donadio, N. Battelli, A. Santinelli, L. Pavesi, A. Lanza, F.A. Zito, A. Labriola, R.A. Aiello, M. Caruso, F. Zanconati, G. Mustacchi, M. Barbareschi, M. Frisinghelli, R. Russo, G. Carrillo, OMERO group. - In: ANNALS OF ONCOLOGY. - ISSN 0923-7534. - 19:10(2008 Oct), pp. 1706-1712. [10.1093/annonc/mdn369]
Biology, prognosis and response to therapy of breast carcinomas according to HER2 score
A. Balsari;
2008
Abstract
BACKGROUND: The standardization of the HER2 score and recent changes in therapeutic modalities points to the need for a reevaluation of the role of HER2 in recently diagnosed breast carcinoma. PATIENTS AND METHODS: A multicenter, retrospective study of 1794 primary breast carcinomas diagnosed in Italy in 2000/2001 and scored in HER2 four categories according to immunohistochemistry was conducted. RESULTS: Ductal histotype, vascular invasion, grade, MIB1 positivity, estrogen and progesterone receptor expression differed significantly in HER2 3+ tumors compared with the other categories. HER2 2+ tumors almost showed values intermediate between those of the negative and the 3+ subgroups. The characteristics of HER2 1+ tumors were found to be in between those of HER2 0 and 2+ tumors. With a median follow-up of 54 months, HER2 3+ status was associated with higher relapse rates in node-positive and node-negative subgroups, while HER2 2+ only in node positive. Analysis of relapses according to type of therapy provided evidence of responsiveness of HER2-positive tumors to chemotherapy, especially taxanes. CONCLUSIONS: The present prognostic significance of HER2 is correlated to receptor expression level and points to the need to consider HER2 2+ and HER2 3+ tumors as distinct diseases with different outcomes and specific features.
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