Department of Pathology and Diagnostics, University of Verona, P.le L. Scuro n. 10, 37134 Verona, Italy.
Anticancer Res. 2013 Sep;33(9):3705-10.
Few data on Human Epidermal Growth Factor Receptor 2 (HER2)-positive breast carcinomas have been reported for screen-detected breast carcinoma. Assessing the impact of a targeted intervention with anti-HER2 inhibitors on costs is required in order to plan for better strategies in screening programs. A total of 54,472 women were screened and 323 cases were found to be invasive cancer. We performed immunophenotypical-fluorescent in situ hybridization (FISH) analysis. Among 153 evaluable breast carcinomas, tumours displayed a 3+ scoring status 3+ in 16 (10%), 2+ in 12 (8%), 1+ in 29 (19%) and 0 in 96 (63%) of cases, respectively. All 3+ HER2+ cases and 2/12 2+ (17%) cases exhibited HER2/neu gene amplification, the remaining cases did not. In contrast to the higher incidence reported at the population level, 20-30% HER2-positive cases for metastatic carcinomas, and only 11% of the screen-detected breast carcinomas displayed HER2/neu gene amplification. Breast cancer detection by screening programs hijacks the skyrocketing cost of the use of targeted therapy in HER2-positive carcinoma.
针对筛查检出的乳腺癌，目前仅有少量关于人表皮生长因子受体 2（HER2）阳性乳腺癌的数据。为了制定更好的筛查计划策略，需要评估针对 HER2 抑制剂的靶向干预对成本的影响。共有 54472 名妇女接受了筛查，发现 323 例为浸润性癌。我们进行了免疫表型-荧光原位杂交（FISH）分析。在 153 例可评估的乳腺癌中，肿瘤的 3+评分状态分别为 16 例（10%）的 3+、12 例（8%）的 2+、29 例（19%）的 1+和 96 例（63%）的 0。所有 3+HER2+病例和 2/12 例 2+（17%）病例均显示 HER2/neu 基因扩增，其余病例则没有。与人群水平报告的较高发病率相比，转移性乳腺癌中 20-30%的 HER2 阳性病例，而仅 11%的筛查检出乳腺癌显示 HER2/neu 基因扩增。筛查计划检测乳腺癌导致针对 HER2 阳性癌的靶向治疗使用成本飙升。
