Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Aug 10;103(4):475-81.
doi: 10.1038/sj.bjc.6605799. Epub 2010 Jul 27.

Increased mortality in HER2 positive, oestrogen receptor positive invasive breast cancer: a population-based study

C A Purdie  1 , L Baker, A Ashfield, S Chatterjee, L B Jordan, P Quinlan, D J A Adamson, J A Dewar, A M Thompson
Affiliations

Increased mortality in HER2 positive, oestrogen receptor positive invasive breast cancer: a population-based study

C A Purdie et al. Br J Cancer. .

Abstract

Background: This study assessed the impact of human epidermal growth factor receptor 2 (HER2) status on the outcomes in an unselected population of breast cancer patients who did not receive HER2-targeted therapy.

Methods: HER2 status by immunohistochemistry and fluorescence in situ hybridisation was compared with clinicopathological data, overall survival (OS) and disease-free survival (DFS) for all patients presenting with breast cancer over 3 years.

Results: In 865 patients (median follow up 6.02 years), HER2 positivity was identified in 13.3% of all cancers and was associated with higher tumour grade (P<10(-8)), lymphovascular invasion (P<0.001) and axillary nodal metastasis (P=0.003). There was a negative association with oestrogen-receptor (ER) and progesterone-receptor expression (P<10(-8)), but the majority (57%) of HER2+tumours were ER+HER2 positivity was associated with poorer OS (P=0.0046) and DFS (P=0.0001) confined to the lymph node-positive (LN+) and ER+ subgroups.

Conclusion: HER2-positive cancers were less common in this population-based cohort than most selected series. The association of HER2 positivity with poor prognosis was confined to the ER+ and LN+ subgroups. The survival deficit for the 7.5% of patients with ER+/HER2+ cancer compared with ER+/HER2- patients points to a significant subgroup of women who may not (currently) be considered for HER2-directed therapy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
CONSORT diagram of patient and tumour groups. a35 patients had 2 tumours, 4 patients had 3 tumours. bTwo patients in this group had two tumours, each. HER2, human epidermal growth factor receptor 2; LN, lymph node.
Figure 2
Figure 2
Kaplan–Meier plots of overall survival for HER2 status, (A) lymph node positive, (B) lymph node negative. (C) ER+, (D) ER–. HER2, human epidermal growth factor receptor 2; ER, oestrogen receptor.
See this image and copyright information in PMC

References

    1. National Health Service Breast Screening Programme (NHSBSP) Guidelines (1995) Pathology reporting in breast cancer screening. Publication No. 3
    1. Buzdar AU, Ibrahim NK, Francis D, Booser DJ, Thomas ES, Theriault RL, Pusztai L, Green MC, Arun BK, Giordano SH, Cristofanilli M, Frye DK, Smith TL, Hunt KK, Singletary SE, Sahin AA, Ewer MS, Buchholz TA, Berry D, Hortobagyi GN (2005) Significantly higher pathologic complete remission rate after neoadjuvant therapy with trastuzumab, paclitaxel, and epirubicin chemotherapy: results of a randomized trial in human epidermal growth factor receptor 2-positive operable breast cancer. J Clin Oncol 23: 3676–3685 - PubMed
    1. Chia S, Norris B, Speers C, Cheang M, Gilks B, Gown AM, Huntsman D, Olivotto IA, Nielsen TO, Gelmon K (2008) Human epidermal growth factor receptor 2 overexpression as a prognostic factor in a large tissue microarray series of node-negative breast cancers. J Clin Oncol 26: 5697–5704 - PubMed
    1. Crowe JP, Patrick RJ, Rybicki LA, Escobar PF, Weng D, Thomas Budd G, Tubbs RR, Procop GW, Hicks DG (2006) A data model to predict HER2 status in breast cancer based on the clinical and pathologic profiles of a large patient population at a single institution. Breast 15: 728–735 - PubMed
    1. Curigliano G, Viale G, Bagnardi V, Fumagalli L, Locatelli M, Rotmensz N, Ghisini R, Colleoni M, Munzone E, Veronesi P, Zurrida S, Nole F, Goldhirsch A (2009) Clinical relevance of HER2 overexpression/amplification in patients with small tumor size and node-negative breast cancer. J Clin Oncol 27: 5693–5699 - PubMed

Substances