Breast Carcinoma; Human Epidermal Growth Factor Receptor-2 (HER-2) and Grading Correlation

Abstract

Introduction: Overexpression of Human Epidermal Growth factor Receptor-2 (HER-2) is one of the most important prognostic and predictive factors of breast cancer, observed in 25% -30% of breast carcinoma patients leading to poor prognosis and feasible anti HER-2 antibody drugs. The objective of this study was to evaluate the HER-2 frequency in target population and its correlation with histologic grade as well as tumor pathology, estrogen receptor (ER) and P53 in our patients. Methods: A total of 300 cases (all female) aged 24-80 year, were randomly selected from patients who were admitted in two of the Tehran University of Medical Sciences affiliated centers (Emam Khomeini Cancer Institute and Shariati hospital) over a 2-year period (2013)(2014). Assessment of tumors for HER-2, P53, ER, pathological type and histologic grade was performed. HER-2 over expression defined as three plus (+++) in immunohistochemistry (IHC). Results: The mean age was 49.6±11 years. HER-2 over expression was seen in 34% of the patients. Significant correlations were found between HER-2+, P53+ and high histologic grade and ER (P<0.05). However, there was no significant correlation between HER-2 and pathologic type of tumors in our study. Conclusion: Co-expression of several poor prognostic biomarkers in breast cancer (HER-2 +, P53 +, ER-, high grade) may predict more aggressive phenotype, worse disease and lower overall survival in these patients.

Prognosis and Predictive Factors Related to Breast Cancer

“…Prognostic factors include the type of tumor, number of involved lymph nodes at the time of diagnosis, size, tumor grade, Ki67 status (cellular marker for proliferation), and the patient's age [7,8]. In addition, some factors are both prognostic and predictive, including estrogen receptor (ER) and progesterone receptor (PR) status, p53 mutation status, and human epidermal growth factor receptor-2 (HER-2/neu) overexpression [9,10]. Numerous studies have been conducted on these prognostic and predictive factors and their relationships with one another.…”

“…ER is a prognostic and predicting factor of breast cancer. ER-positive patients have a better prognosis than ER-negative ones and better respond to anti-estrogen agents, which have become an important principle in the treatment of breast cancer [8,9]. Numerous studies have revealed that ER-positive tumors show lower response to hormone therapy than HER-2-negative and ER-positive tumors; this seems to be due to the intracellular functional interference of HER-2-negative with hormone receptors which result in resistance of some ER-positive tumors to tamoxifen [10].…”

“…The researchers indicated that due to a weak possibility of positivity of HER-2 in lobular carcinoma, routine assessment of HER-2 is not necessary, while the highest HER-2-positive was seen in ductal carcinoma of NST. Therefore, there is a specific and significant relationship between HER-2-positive and ductal invasive carcinoma of breast [9,10,17].…”

“…Another prognostic factor is tumor grade; higher tumor grades are associated with an increased degree of relapse, greater extent of involvement, and higher chance of distant metastasis. In one study, grade 2 tumors were more prevalent than the other tumor grades (1 and 3), and lobular carcinomas had the highest frequency of grade 2 tumors, followed by invasive ductal carcinomas [3,9,10]…”