new article on prognostic importance (or lack of it) of her2 +ivity on IBC

[Lani]

Breast Cancer Res. 2009 Feb 19;11(1):R9. [Epub ahead of print]

Prognostic impact of HER2 and hormone receptor status in inflammatory breast cancer (IBC): analysis of 2014 IBC patient cases from the California Cancer Registry.

Zell JA, Tsang WY, Taylor TH, Mehta RS, Anton-Culver H.
ABSTRACT: INTRODUCTION: Inflammatory breast cancer (IBC) is an aggressive form of breast cancer associated with over-expression of Her-2-Neu (HER2) and poor survival. We investigated survival differences for IBC patient cases based on hormone and HER2 receptor status using data from the California Cancer Registry (CCR), as contrasted with locally-advanced breast cancer (LABC), metastatic breast cancer (MBC) and non-T4 breast cancer. METHODS: A case-only analysis of 80,099 incident female breast cancer patient cases in CCR during 1999 - 2003 was performed, with follow-up through March 2007. Overall survival (OS) and breast cancer-specific survival (BC-SS) was analyzed using Kaplan-Meier methods and Cox proportional hazards ratios (HR). RESULTS: 2014 IBC, 1268 LABC, 3059 MBC, and 73,758 non-T4 breast cancer patient cases were identified. HER2+ was associated with advanced tumor stage (P <0.0001). IBC patient cases were more likely to be HER2+ (40%) and less likely to be hormone receptor positive (HmR+) (59%) compared to LABC (35%, 69%), MBC (35%, 74%), and non-T4 patient cases (22%, 82%). HmR+ status was associated with improved OS and BC-SS for each breast cancer subtype after adjustment for clinically relevant factors. In multivariate analysis, HER2+ (versus HER2-) status was associated with poor BC-SS for non-T4 patient cases (HR = 1.16, 95% confidence interval (CI) 1.05 - 1.28) and had a borderline significant association with improved BC-SS for IBC (HR = 0.82, 95% CI 0.68 - 0.99). CONCLUSIONS: Despite an association with advanced tumor stage, HER2+ status is not an independent adverse prognostic factor for survival among IBC patient cases.
PMID: 19228416