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. 2013 Jun;8(3):208-14.
doi: 10.1159/000352094.

Association of HER2 Overexpression and Prognosis in Small (T1N0) Primary Breast Cancers

Joachim Rom  1 , Claudia Schumacher  2 , Oleg Gluz  3 , Josef Höfler  4 , Sebastian Eidt  5 , Christoph Domschke  1 , Frederik Marmé  6 , Ulrike Nitz  3 , Christof Sohn  1 , Andreas Schneeweiss  6
Affiliations

Association of HER2 Overexpression and Prognosis in Small (T1N0) Primary Breast Cancers

Joachim Rom et al. Breast Care (Basel). 2013 Jun.

Abstract
in English, German

Background: There is some controversy regarding the precise role and need for adjuvant therapy in patients with pT1a/pT1bN0 breast cancer, although studies have indicated that a HER2-positive status is one of the most powerful poor prognostic factors.

Patients and methods: We retrospectively evaluated disease-free survival (DFS), distant disease-free survival (DDFS), and overall survival (OS) among 960 patients diagnosed between 2000 and 2008 with T1N0 primary breast cancer treated at 3 German centers, and determined prognostic risk factors. Univariate analysis was used to determine associations with potential risk factors.

Results: With a median follow-up of 23 months, DFS was 94.8%, DDFS 96.3%, and OS 97.5%. Risk factors for decreased 1-year DFS were: peritumoral lymphatic invasion (L1) (p = 0.031), negative hormone receptor status (p = 0.003), non-use of hormonal therapy (p = 0.001), and a positive HER2 status (p = 0.003). Amongst the HER2-positive patients only 2.7% (n = 1/37) of those treated with trastuzumab had a DFS event compared with 20% (n = 10/50) without trastuzumab.

Conclusion: Patients with HER2-positive T1 breast cancer should be considered for inclusion in prospective trials of trastuzumab in combination with chemotherapy to determine the risk-to-benefit ratio and association with other prognostic factors.

Hintergrund: Die Bedeutung und der Nutzen einer adjuvanten Therapie bei Patientinnen mit einem pT1a/pT1bN0-Mammakarzinom wird kontrovers diskutiert. In einigen Studien konnte ein positiver HER2-Status als einer der stärksten prognostischen Faktoren nachgewiesen werden. Patientinnen und Methoden: In dieser Studie wurde retrospektiv an 3 deutschen Brustzentren das krankheitsfreie Überleben (DFS), das distant krankheitsfreie Überleben (DDFS) und das Gesamtüberleben (OS) von 960 Patientinnen, die zwischen 2000 und 2008 an einem primären Mammakarzinom < 2 cm (T1N0) erkrankten, ausgewertet. Zusätzlich wurden die prognostischen Faktoren untersucht. Der Zusammenhang mit potentiellen Risikofaktoren wurde durch univariate Analysen untersucht. Ergebnisse: Die mediane Nachbeobachtungszeit betrug 23 Monate, DFS war 94,8%, DDFS 96,3% und OS 97,5%. Risikofaktoren für ein kürzeres 1-Jahres-DFS waren: peritumorale lymphatische Invasion (L1) (p = 0,031), negativer Hormonrezeptorstatus (p = 0,003), keine adjuvante hormonelle Therapie (p = 0,001) und ein positiver HER2-Status (p = 0,003). Bei Patientinnen, die mit Trastuzumab behandelt wurden, trat nur bei 2,7% (n = 1/37) ein DFS-Ereignis auf, bei Patienten ohne Trastuzumab-Therapie war dies bei 20% (n = 10/50) der Fall. Schlussfolgerung: Patienten mit einem HER2-positiven Mammakarzinom < 2 cm sollten in prospektive Studien eingeschlossen werden, um die Bedeutung der Trastuzumab-Therapie in Kombination mit Chemotherapie, das Nutzen-Risiko-Verhältnis und die Bedeutung anderer Riskiofaktoren untersuchen zu können.

Keywords: Adjuvant treatment; Disease-free survival; HER2/neu; High-risk breast cancer; Trastuzumab.

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Figures

Fig. 1
Fig. 1
Kaplan-Meier plot of disease-free survival for patients with T1N0 breast tumors.
Fig. 2
Fig. 2
Kaplan-Meier plot of disease-free survival for patients with T1N0 breast tumors according to HER2 status: HER2-negative (green) and HER2-positive (red).
See this image and copyright information in PMC

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References

    1. Schootman M, Jeffe D, Reschle A, Aft R. The full potential of breast cancer screening use to reduce mortality has not yet been realized in the United States. Breast Cancer Res Treat. 2004;85:219–22. - PubMed
    1. Benson JR, Jatoi I, Keisch M, Esteva FJ, Makris A, Jordan VC. Early breast cancer. Lancet. 2009;373:1463–79. - PubMed
    1. Jemal A, Clegg LX, Ward E, Ries LA, Wu X, Jamison PM, Wingo PA, Howe HL, Anderson RN, Edwards BK. Annual report to the nation on the status of cancer, 1975-2001, with a special feature regarding survival. Cancer. 2004;101:3–27. - PubMed
    1. Rosen PP, Saigo PE, Braun DW, Weathers E, DePalo A. Predictors of recurrence in stage I (T1N0M0) breast carcinoma. Ann Surg. 1981;193:15–25. - PMC - PubMed
    1. Rosen PP, Groshen S, Saigo PE, Kinne DW, Hellman S. A longer-term follow-up study of survival in stage I (T1N0M0) and stage II (T1N1M0) breast carcinoma. J Clin Oncol. 1989;7:355–66. - PubMed