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Annals of Oncology Advance Access published online on February 16, 2009
Annals of Oncology, doi:10.1093/annonc/mdp003
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Tissue microarray-based study of patients with lymph node-negative breast cancer shows that HER2/neu overexpression is an important predictive marker of poor prognosis

Y. H. Choi1, J. H. Ahn1,*, S.-B. Kim1, K.-H. Jung1, G.-Y. Gong2, M.-J. Kim2, B.-H. Son3, S.-H. Ahn3 and W. K. Kim1

1 Department of Interanl Medicine
2 Department of Pathology
3 Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

* Correspondence to: Dr J.-H. Ahn, MD, Division of Oncology, Department of Medicine, Asan Medical Center, University of Ulsan College of Medicine, 388-1, Pungnap-dong, Songpa-gu, Seoul 138-736, South Korea. Tel: +82-2-3010-3210; Fax: +82-2-3010-6961; E-mail: drjiny{at}amc.seoul.kr

Background: Despite good prognosis in most cases of lymph node (LN)-negative breast cancer, individual patients may have markedly different clinical outcomes. Here, we investigated the prognostic significance of HER2/neu overexpression in these tumors.

Materials and methods: We employed a tissue microarray to examine HER2/neu overexpression by immunohistochemical staining in 359 consecutive patients diagnosed with LN-negative breast cancer, who underwent surgery from January 1993 to December 1998.

Results: HER2/neu overexpression was detected in 81 of 359 (23.1%) patients. The 10-year disease-free survival (DFS) values (81.2% versus 61.8%, P value 0.000) and overall survival (OS) rates (85.7% versus 63.9%, P value 0.000) were significantly different between cases with HER2/neu-negative or HER2/neu-positive tumors. After multivariate analysis, HER2/neu status and tumor size were identified as independent prognostic factors for 10-year OS. Moreover, HER2/neu overexpression was significantly associated with poorer clinical outcomes in an intermediate-risk group identified by the St Gallen classification (10-year DFS, 79.6% versus 61.8%, P value 0.000; 10-year OS, 84.7% versus 63.9%, P value 0.000).

Conclusions: Our results show that HER2/neu overexpression is an important independent prognostic factor for LN-negative breast cancer cases and support the theory that more intensive adjuvant chemotherapy is required in the population with HER2/neu overexpression.

adjuvant chemotherapy, breast cancer, HER2/neu, prognosis

Received for publication October 2, 2008. Accepted for publication December 22, 2008.


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