Her2 and prognosis - here\'s a 30 year study

OK, all the posts lately on her2s and recurrance made me spend about 2 hours on the internet last night. This is a Finish study from several years ago that studied women who were 30 years out from dx, and whether her2 was a predictor of more poor prognosis. No surprise, it was. But then again, almost all the literature support that. Here is what I think is neat - the 25 year survival rate was 31% for those that are her2+, and 39% for those that are her2-. That is considered statistically significantly worse, but only because of the basis of the numbers (31% is not 8% worse than 39%, but on a relative basis, it is 25% worse.) If I read this correctly, with those with negative nodes, it didn't matter if they were her2+ or not.

I know the her2 tests are a little different now, but here is the great news!! These stats were with these women receiving NO CHEMOTHERAPY, let alone HERCEPTIN! Back then, I think they cut it out and did radiation - no systemmatic treatment to get what is in your blood that can come back to an organ. So overall long-term her2 stats have to be much more positive than that today. I don't know about you, but even though the stats here were grim, this article gave me a lot of hope.....

http://www.jco.org/cgi/content/abstract/10/7/1044

I found another one. Don't know how to add a web site address, so I just copied the abstract. It seems to say that prognosis for Her2 positive cancers can be unfavorable or not unfavorable, depending on nodal status and the presence or absence of an inflammatory reaction withing the tumor. (this means that your immune system was busy attacking the cancer when it was excised).


Division of Anatomical Pathology, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milan, Italy.

Archival surgical specimens from 1,210 female breast cancer patients treated between 1968 and 1971 and with a 19-year follow-up were reanalyzed with special reference to several parameters, such as size of the primary tumor, axillary nodal involvement, histologic grade, degree of inflammatory infiltrate (LPI) of the tumor and expression of the neu oncoprotein (p185) as detected by immunohistochemistry. In a multifactorial analysis the 4 former factors were found to be independent prognostic parameters. Over-expression of p185 was found to be related to tumor size and grade and to LPI but not to pathologic nodal status. Over-expression of p185 showed a negative impact upon survival in node-positive but not in node-negative patients. However, in the subset of node-negative patients without LPI, p185 over-expression showed the same correlation with a poor prognosis as in node-positive patients. In contrast, in node-negative and LPI-positive patients, p185 over-expression correlated with a good prognosis. Also, the prognosis of patients with positive nodes, presence of LPI and no p185 over-expression was similar to that of patients with negative nodes, absence of LPI and p185 over-expression.