HER2 Status Associated with Recurrence in Node-Negative Breast Cancer Presented

[RhondaH]

HER2 Status Associated With Recurrence in Node-Negative Breast Cancer: Presented at SSO (javascript:ol('http://www.docguide.com/news/content.nsf/news/852571020057CCF6852572A3006CC0D5');)
[Doctor's Guide (javascript:ol('http://www.docguide.com/');)]
WASHINGTON, DC — March 19, 2007 — Absence of cancerous cells in sentinel lymph nodes (SLNs) is generally taken as predicting good prognosis in breast cancer. But, according to research presented here at the 60th annual meeting of the Society of Surgical Oncology (SSO), node-negative patients whose tumours express the HER2 protein may be at higher-than-expected risk for cancer recurrence.
Julie E. Lang, MD, surgical oncology fellow, University of Texas M. D. Anderson Cancer Center, Houston, Texas, United States, reported on a retrospective analysis of women who underwent primary breast tumour resection and SLN dissection.
The research was performed at her former institution, the University of California-San Francisco, San Francisco, California, United States.
Dr. Lang's analysis included 307 patients who were found to be SLN-negative. Of these, 53 had primary tumours that were positive for HER2 by immunohistochemistry and/or fluorescent hybridization in situ methods, while 198 were HER2-negative and the remaining 56 had inconclusive or missing data on HER2 status. Patients were followed for a mean of 4.1 years.
In a poster presentation March 16th Dr. Lang said that this is one of the larger studies to look at HER2 status as a prognostic factor in node-negative breast cancer.
Results of the analysis showed that HER2-positive patients in the series were significantly more likely to have cancer recurrence — both systemic (P < .01) and locoregional (P = .038) — and had a higher mortality rate (P < .01).
Recurrence-free survival was markedly worse in HER2-positive women. Five years after resection, nearly 95% of HER2-negative patients had survived disease-free versus 70% of HER2-positive patients (P = .0006).
The analysis found no significant association between HER2 and SLN status.
In short, the study suggested that negative SLN findings do not necessarily predict good prognosis in HER2-positive patients.

[RobinP]

Rhonda, the test sounds interesting and a little hooky. Are you sure your resources are ligitimate? The test sounds too good to be true.

[RhondaH]

Lani emailed the article to me and asked me to post it as she is having difficulty. I've been so busy, I honestly didn't even read it...sorry.

Rhonda

[caya]

Let's look at the data here -

# 1- hey, we all know that Her 2neu+ is a more aggresive cancer, I'm not surprised that after 5 years the Her2+ women had a higher rate of recurrence - DFS at 70% versus 95% of Her2 negative - but again -

#2 - Were these women (presumably stage 1 or 2, since they were node-negative) on Herceptin? chemo/Herceptin? That is very important to know, because the HERA trials with early stagers, both node+ and node-, had overall survival at 92.4% and DFS at 80.6% after 2 years. (the only data they had, still waiting for longer stats). An article on breastcancer.org from Genetch Inc. dated 2006-11-17 - "The studies have shown that 87 percent of women treated with Herceptin and chemo were disease-free after three-and-a-half years, compared with 71 percent of women treated with chemo alone, the company said. (nothing about nodes)

# 4 - Another comment from Dr. Sandra M. Swain in an article at www.patternsofcare.com/2006/1/adjuvant-trastuzumab.asp (http://www.patternsofcare.com/2006/1/adjuvant-trastuzumab.asp) - "In the HERA trial, approximately 30 percent of the patients had node-negative disease. The HERA trial was very strongly positive for efficacy with sequential trastuzumab in the patients with node-negative disease."

# 3 - I wonder if they have information on regular axillary node dissections. SLN biopsy can miss up to 10% of cancer cells, according to what I have researched.

# 4 - I wish they had information on MRM - I am assuming "primary tumour resection" means a lumpectomy.


I think I have raised a few issues here. Like we are always saying, we are rewriting the stats every day - you'll see, the 5 year rates in 5 years from now will be great, because we'll all have been on Herceptin (and possibly Tykerb).
Have a great weekend everyone -
Caya

[Hopeful]

I am wondering if Robin P meant to respond to the thread about the article with saliva testing, and not this poster? FWIW, I saw the story (i.e. the saliva test) reported on Fox News yesterday morning.

Hopeful