This is a slightly smaller study of about 120 her2+ bc patients, which does reach statistical significance. It is reflective of slighter higher survival stats in the first five years than the previous article that I posted by SABC, abstract 701. Again, the article eludes to the fact that probably these study patients did not receive adjuvant tx with herceptin and chemo., which probably would have positively increased survival rates, according to the HERA trial and other studies.
[6058] HER2 amplification does not alter outcome in small (1 cm) tumors.
Ananthakrishnan P, Patrick RJ, Rybicki LA, Tubbs RR, Crowe JP, Budd GT Cleveland Clinic Foundation, Cleveland, OH
INTRODUCTION: Amplification of human epidermal growth factor receptor-2 (
HER2) has been associated with an aggressive clinical phenotype, however the management of patients with small tumors (
<1 cm) that amplify
HER2 is controversial. The goals of this study were: 1) to describe characteristics of
HER2 amplified tumors based on tumor size, and 2) compare outcomes among 4 groups based on tumor size (small tumors
<1 cm or large tumors >1 cm) and
HER2 amplification (+ or -.)
METHODS: Data were collected prospectively in our institutional review board approved breast center patient registry for patients with infiltrating ductal or infiltrating ductal-lobular mixed breast cancer. There were 770 patients with N0 tumors who were diagnosed between January 2001 and April 2005 (prior to treatment of
HER2 amplified tumors with Trastuzumab). Categorical variables were compared using the Chi-squared test; outcomes were estimated using the Kaplan-Meier method and the log-rank test.
RESULTS: At 4 years, estimated disease free interval was 97% in small
HER2- tumors, 92% in large
HER2- tumors, 91% in small
HER2+ tumors, and 86% in large
HER2+ tumors.
At 4 years, breast cancer specific survival was 97% in small
HER2- tumors, 92% in large
HER2- tumors, 91% in small
HER2+ tumors, and 86% in large
HER2+ tumors.
CONCLUSIONS: In our series, larger as opposed to smaller
HER2+ tumors tended to be of higher histologic grade (SBR), and showed a trend toward more frequent lymphovascular invasion (LVI) and negative hormone receptor status. In small tumors,
HER2 amplification did not predict recurrence-free survival or breast cancer disease specific survival at 4 years. The survival curves do show trends towards worsening outcomes for small tumors with
HER2 amplification; these trends may show significance with additional follow-up.
Sunday, December 14, 2008 7:00 AM
Poster Session VI: Prognosis and Response Predictions: Response Predictions - Biomarkers and Other Factors (7:00 AM-9:00 AM)
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