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Early peak of relapse due to micromets?
European Journal of Cancer
Volume 42, Issue 8 , May 2006, Pages 1057-1061
Linking survival of HER2-positive breast carcinoma
patients with surgical invasiveness
Elda Tagliabuea, d, Roberto Agrestia, d, Patrizia
Casalinia, Luigi Mariania, Maria Luisa Carcangiua,
Andrea Balsarib, Umberto Veronesic and Sylvie Ménarda,
,
aIstituto Nazionale per lo Studio e la Cura dei
Tumori, via Venezian 1, 20133 Milan, Italy
bInstitute of Pathology, University of Milan, via
Mangiagalli 31, 20133 Milan, Italy
cEuropean Institute of Oncology, via Ripamonti 435,
20141 Milan, Italy
Received 23 June 2005; revised 8 November 2005;
accepted 20 December 2005. Available online 18 April
2006.
Abstract
The early peak of relapse in patients with breast
carcinomas that overexpress HER2 oncoprotein and
dissemination to the axillary lymph nodes might be
related to proliferation of micrometastatic lesions
induced by EGF family growth factors released at the
time of surgery. If the levels of these growth factors
have an impact on relapse, the survival of patients
with positive nodes and HER2-positive tumours should
be dependent on surgery wideness. To test this
hypothesis, HER2 status of primary tumours from
patients included in a randomized clinical trial
addressing conservative quadrantectomy versus radical
mastectomy was retrospectively analyzed. In
HER2-negative patients, independently of node
infiltration, and in HER2-positive patients without
node infiltration, no differences in survival
according to the type of surgery were observed. In
patients with positive nodes and HER2-positive tumours
the estimation of the time-dependent log-hazard ratios
showed that radical mastectomy significantly increased
early death rates (P = 0.037).
Corresponding author: Tel.: + 39 02 23902571; fax: +39
02 23903073.
d Equally contributing authors.
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