Cicin Irfan, Karagol Hakan, Usta Ufuk, Sezer Atakan, Uzunoglu Sernaz, Alas-Cosar Rusen, Yetisyigit Tarkan, Uygun Kazim
Department of Medical Oncology, Faculty of Medicine, Trakya University, Hastanesi Medikal Onkoloji Bilim Dali, 22030 Edirne, Turkey.
Med Oncol. 2009;26(3):335-43. doi: 10.1007/s12032-008-9126-3. Epub 2008 Nov 12.
The aim of this study is to reveal likely demographic, clinical, and pathological differences among hormone receptor negative breast cancer patients according to their HER-2 status. The medical records of hormone receptor negative breast cancer patients with known HER-2 status between January 1999 and December 2006 were reviewed, retrospectively. A total of 91 cases were included in the study (68 HER-2 negative cases and 23 HER-2 positive cases). The results obtained showed that median age, menarche age, childbearing age, number of children, menopause age, and body-mass indexes were similar in both groups. The HER-2 negative patients had more family history of breast cancer than HER-2 positive patients (13.2% and 0%, respectively, P = 0.091). Eighty-three patients received neoadjuvant/adjuvant chemotherapy. Recurrence occurred in 41 (46.6%) patients. Neither recurrence nor disease-free survival of those patients was associated with HER-2 status. Tumor size (P = 0.042) and number of involved lymph nodes (P = 0.001) were found to be independent prognostic factors for disease-free survival. A tendency for more frequent cerebral metastasis was found in HER-2 positive advanced stage patients (P = 0.052). HER-2 positive patients were less responsive to taxanes (P = 0.071). The number of involved lymph nodes (P = 0.004) and HER-2 status (P = 0.043) were found to be prognostic factors for overall survival. HER-2 positive and negative patients should be followed and treated with different strategies. HER-2 positive patients are at least as resistant to systemic therapies as the HER-2 negative patients. Genetic counseling should be routinely provided to triple negative patients and their families. HER-2 positive patients may be candidates for prophylactic treatment strategies concerning cerebral metastasis.
本研究的目的是揭示激素受体阴性乳腺癌患者根据其HER-2状态在人口统计学、临床和病理方面可能存在的差异。回顾性分析了1999年1月至2006年12月间已知HER-2状态的激素受体阴性乳腺癌患者的病历。本研究共纳入91例患者(68例HER-2阴性病例和23例HER-2阳性病例)。结果显示,两组患者的年龄中位数、初潮年龄、生育年龄、子女数、绝经年龄和体重指数相似。HER-2阴性患者的乳腺癌家族史比HER-2阳性患者更多(分别为13.2%和0%,P = 0.091)。83例患者接受了新辅助/辅助化疗。41例(46.6%)患者出现复发。这些患者的复发情况和无病生存期均与HER-2状态无关。肿瘤大小(P = 0.042)和受累淋巴结数量(P = 0.001)被发现是无病生存期的独立预后因素。在HER-2阳性晚期患者中发现有更频繁发生脑转移的趋势(P = 0.052)。HER-2阳性患者对紫杉烷类药物的反应较差(P = 0.071)。受累淋巴结数量(P = 0.004)和HER-2状态(P = 0.043)被发现是总生存期的预后因素。HER-2阳性和阴性患者应采用不同的策略进行随访和治疗。HER-2阳性患者对全身治疗的耐药性至少与HER-2阴性患者相同。应常规为三阴性患者及其家属提供遗传咨询。HER-2阳性患者可能是关于脑转移预防性治疗策略的候选对象。