Elsevier

Apollo Medicine

Volume 10, Issue 4, December 2013, Pages 313-317
Apollo Medicine

Research Article
Correlation of Her-2 neu over-expression with clinico pathological features of carcinoma breast

https://doi.org/10.1016/j.apme.2013.10.012Get rights and content

Abstract

Purpose

To determine the relationship between Her-2 neu over-expression and clinico pathological features of carcinoma breast.

Methods

150 patients with carcinoma breast, were assessed for Her-2 neu over-expression as a prospective study. Oestrogen (ER) and progesterone receptor (PR) status along with other clinico pathological parameters of tumour size, node status, type and grade of tumour were assessed.

Results

Her-2 neu over-expression was seen in 32.30% of patients who were ER and PR negative and in 11.94% of those who were ER and PR positive. It was unrelated to the other clinico pathological parameters.

Conclusions

Significant correlation between Her-2 neu amplification and ER/PR negative tumours was found but not with other clinico pathological parameters.

Introduction

The classical clinico pathological features such as tumour size, axillary node status, histological type and grade have a well-established prognostic role in breast cancer. However, they do not allow patients to be stratified for appropriate therapy on an individual basis. Biological markers such as oestrogen (ER) and progesterone receptors (PR) are of value in individualizing therapy and have become standard of care. Similarly, assessment of Her-2 neu over-expression has become the norm because it provides both prognostic and therapeutic information.

There is no consensus in literature on the relationship between Her-2 neu over-expression and the classical clinico pathological features.1, 2 But, nearly all investigators report an inverse relationship between Her-2 neu status and hormone receptors in diverse populations.3, 4, 5 The purpose of this study was to verify whether such correlations existed in our patients. To this end, the association between Her-2 neu over-expression and oestrogen and progesterone receptor status (both independently and jointly) and other clinico pathological features, that is, tumour size, node status, type of tumour and grade of tumour were studied.

Section snippets

Patients and methods

This was a prospective study accumulating 150 breast cancer patients over a 5 year period from 2004. All specimens of definitive surgery were fixed in 10% formaldehyde, embedded in paraffin, sectioned and stained with Haematoxylin/Eosin. Pathological staging (pTNM),6 determination of tumour type as per WHO classification,7 and grading by the Nottingham system8, 9 was done.

ER and PR status were assessed by immuno histochemistry either on the pre operative core biopsy sample or the surgical

Statistical analysis

All statistical analyses were performed with SPSS software version 15.1 for Windows (SPSS Inc, Chicago, Illinois, USA) and Epi Info™ (Version 6). The χ2 test was used to examine the association between Her-2/neu status and the various categorical variables in univariate analysis. p values less than 0.05 were accepted as significant.

Results

Table 1 summarises the clinico pathological features of all 150 patients.

Her-2 neu over-expression was seen in 35 (23.3%) out of the 150 patients. The mean age of the patients was 51.29 years. The youngest patient was 26 and the oldest 85 years. Only 7 out of 25 patients (28%) who were ≤age 40 were Her-2/neu positive. In the 125 who were ≥41 years, 28 (22.4%) were Her-2 neu positive. For younger vs. older patients: Odds ratio = 1.35. 95% CI 0.46–3.87. Relative risk = 1.25 (p = 0.7298443 Yates

Discussion

Classical clinical and morphological prognostic factors, such as tumour size, axillary node status, histological grade and type, vascular invasion etc. have a well-established role in the management of breast cancer.

Advances in the understanding of the molecular and genetic alterations underlying breast cancer development and progression have resulted in the identification of a great number of cell biological markers which are of potential value in individualizing therapy.12, 13

The HER-2 neu

Conclusion

The estimation of ER, PR and Her-2 neu in breast cancer is now standard of care, but the relationship between these and other traditional prognosticators is still not clear. In this study of 150 breast cancers, significant correlation between Her-2 neu amplification and ER/PR negative tumours was found but such was not so with other clinico pathological parameters.

Presentation details

Organisation: Association of Surgeons of India, Tamil Nadu & Pondicherry State Chapter Conference (NAGASICON 2009).

Place: Kanya Kumari, Tamil Nadu.

Date: 2nd August, 2012.

Conflicts of interest

All authors have none to declare.

References (29)

  • D. Cameron et al.

    Optimizing treatment for patients with breast cancer

    Semin Oncol

    (2004)
  • S. Eppenberger-Castori et al.

    Age-associated biomarker profiles of human breast cancer

    Int J Biochem Cell Biol

    (2002)
  • H. Boussen et al.

    Inflammatory breast cancer in Tunisia: reassessment of incidence and clinicopathological features

    Semin Oncol

    (2008)
  • R. Prati et al.

    Histopathologic characteristics predicting HER-2/neu amplification in breast cancer

    Breast J

    (2005)
  • H.J. Huang et al.

    Association between tumour characteristics and HER-2/neu by immunohistochemistry in 1362 women with primary operable breast cancer

    J Clin Pathol

    (2005)
  • N.M. Almasri et al.

    Immunohistochemical evaluation of human epidermal growth factor receptor 2 and estrogen and progesterone receptors in breast carcinoma in Jordan

    Breast Cancer Res

    (2005)
  • A. Traina et al.

    HER2/neu expression in relation to clinicopathologic features of breast cancer patients

    Ann N Y Acad Sci

    (2006)
  • R. Peredo et al.

    Her-2/neu oncogene expression in Puerto Rican females with breast cancer

    Cell Mol Biol (Noisy-le-grand)

    (2001)
  • Histological typing of breast tumours

    International Classification of Tumours

    (1981)
  • H.J.G. Bloom et al.

    Histological grading and prognosis in breast carcinoma: a study of 1049 cases of which 359 have been followed for 15 years

    Br J Cancer

    (1957)
  • Fitzgibbons PL, Page DL, Weaver D, et al. Prognostic factors in breast cancer: College of American Pathologists...
  • DAKO HercepTest® Package insert

    (2004)
  • R.W. Carlson et al.

    HER2 testing in breast Cancer: NCCN Task Force report and recommendations

    J Natl Compr Canc Netw

    (2006)
  • Cited by (0)

    View full text