This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Joensuu, H. Articles by Lundin, J. Search for Related Content PubMed PubMed Citation Articles by Joensuu, H. Articles by Lundin, J.

Amplification of erbB2 and erbB2 Expression Are Superior to Estrogen Receptor Status As Risk Factors for Distant Recurrence in pT1N0M0 Breast Cancer

A Nationwide Population-based Study¹

Departments of Oncology [H. J., M. L., T. S., J. L.] and Surgery [K. v. S.], Helsinki University Central Hospital, FIN-00029 Helsinki; Laboratory of Cancer Genetics, Institute of Medical Technology, University and University Hospital of Tampere, Tampere [J. I.]; Department of Palliative Medicine, Tampere University Hospital, Tampere [K. H.]; Department of Oncology, Kuopio University Hospital, Kuopio [V. K.]; Department of Oncology, Turku University Central Hospital, Turku [L. P.]; Department of Oncology and Radiotherapy, Oulu University Central Hospital University, Oulu [T. T-H.], Finland

Purpose: To assess the relative importance of 10 prognostic factors in pT1N0M0 breast cancer (2 cm in diameter, node negative).

Experimental design: Women diagnosed with breast cancer in Finland from 1991 to 1992 were identified from the files of the Finnish Cancer Registry, and individual clinicopathological data were collected from the hospital case records of women living in five regions comprising about one-half of the Finnish population. Of the women with minimum required information available (n = 2842), 852 had unilateral pT₁N₀M₀ cancer. The median follow-up time was 9.5 years, and only 5% had received systemic adjuvant therapy. Estrogen receptor (ER), progesterone receptor, erbB2, p53, and Ki-67 expression was determined from tumor tissue microarrays using immunohistochemistry, and the erbB2 (HER-2) amplification status was determined using chromogenic in situ hybridization.

Results: Primary tumor size 5 mm and histological grade 1 were associated with 100 and 95% (95% confidence interval, 92–98%) 9-year distant disease-free survival, respectively, whereas strong erbB2 expression or the presence of >20% Ki-67-positive cells was associated with >20% risk. ER and progesterone receptor values obtained from the hospital case records or tumor microarrays showed weaker association with outcome than the erbB2 status. Small (10 mm) erbB2-negative cancers were associated with >90% 9-year distant disease-free survival, irrespective of histological grade.

Conclusions: Prognosis of pT₁N₀M₀ breast cancer is generally well defined by the histological grade and primary tumor size. The erbB2 status was superior to ER as a prognostic factor in these tumors.

This article has been cited by other articles:

				H. Sihto, J. Lundin, T. Lehtimaki, M. Sarlomo-Rikala, R. Butzow, K. Holli, L. Sailas, V. Kataja, M. Lundin, T. Turpeenniemi-Hujanen, et al. Molecular Subtypes of Breast Cancers Detected in Mammography Screening and Outside of Screening Clin. Cancer Res., July 1, 2008; 14(13): 4103 - 4110. [Abstract] [Full Text] [PDF]

				E. Azambuja, V. Durbecq, D. D. Rosa, M. Colozza, D. Larsimont, M. Piccart-Gebhart, and F. Cardoso HER-2 overexpression/amplification and its interaction with taxane-based therapy in breast cancer Ann. Onc., February 1, 2008; 19(2): 223 - 232. [Abstract] [Full Text] [PDF]

				L. Harris, H. Fritsche, R. Mennel, L. Norton, P. Ravdin, S. Taube, M. R. Somerfield, D. F. Hayes, and R. C. Bast Jr American Society of Clinical Oncology 2007 Update of Recommendations for the Use of Tumor Markers in Breast Cancer J. Clin. Oncol., November 20, 2007; 25(33): 5287 - 5312. [Abstract] [Full Text] [PDF]

				R. I. Aqeilan, V. Donati, E. Gaudio, M. S. Nicoloso, M. Sundvall, A. Korhonen, J. Lundin, J. Isola, M. Sudol, H. Joensuu, et al. Association of Wwox with ErbB4 in Breast Cancer Cancer Res., October 1, 2007; 67(19): 9330 - 9336. [Abstract] [Full Text] [PDF]

				E. O. Hanrahan, V. Valero, A. M. Gonzalez-Angulo, and G. N. Hortobagyi Prognosis and Management of Patients With Node-Negative Invasive Breast Carcinoma That Is 1 cm or Smaller in Size (stage 1; T1a,bN0M0): A Review of the Literature J. Clin. Oncol., May 1, 2006; 24(13): 2113 - 2122. [Abstract] [Full Text] [PDF]

				A. Urruticoechea, I. E. Smith, and M. Dowsett Proliferation Marker Ki-67 in Early Breast Cancer J. Clin. Oncol., October 1, 2005; 23(28): 7212 - 7220. [Abstract] [Full Text] [PDF]

				N. Linder, J. Lundin, J. Isola, M. Lundin, K. O. Raivio, and H. Joensuu Down-Regulated Xanthine Oxidoreductase Is a Feature of Aggressive Breast Cancer Clin. Cancer Res., June 15, 2005; 11(12): 4372 - 4381. [Abstract] [Full Text] [PDF]

				T. T. Junttila, M. Sundvall, M. Lundin, J. Lundin, M. Tanner, P. Harkonen, H. Joensuu, J. Isola, and K. Elenius Cleavable ErbB4 Isoform in Estrogen Receptor-Regulated Growth of Breast Cancer Cells Cancer Res., February 15, 2005; 65(4): 1384 - 1393. [Abstract] [Full Text] [PDF]

				H. Sihto, M. Sarlomo-Rikala, O. Tynninen, M. Tanner, L. C. Andersson, K. Franssila, N. N. Nupponen, and H. Joensuu KIT and Platelet-Derived Growth Factor Receptor Alpha Tyrosine Kinase Gene Mutations and KIT Amplifications in Human Solid Tumors J. Clin. Oncol., January 1, 2005; 23(1): 49 - 57. [Abstract] [Full Text] [PDF]

				Y. Kun, L. C. How, T. P. Hoon, V. B. Bajic, T. S. Lam, A. Aggarwal, H. G. Sze, W. S. Bok, W. C. Yin, and P. Tan Classifying the estrogen receptor status of breast cancers by expression profiles reveals a poor prognosis subpopulation exhibiting high expression of the ERBB2 receptor Hum. Mol. Genet., December 15, 2003; 12(24): 3245 - 3258. [Abstract] [Full Text] [PDF]

				R. Nahta and F. J. Esteva HER-2-Targeted Therapy: Lessons Learned and Future Directions Clin. Cancer Res., November 1, 2003; 9(14): 5078 - 5084. [Abstract] [Full Text] [PDF]

				W. P. Carney, R. Neumann, A. Lipton, K. Leitzel, S. Ali, and C. P. Price Potential Clinical Utility of Serum HER-2/neu Oncoprotein Concentrations in Patients with Breast Cancer Clin. Chem., October 1, 2003; 49(10): 1579 - 1598. [Abstract] [Full Text] [PDF]

				J. S. Ross, J. A. Fletcher, G. P. Linette, J. Stec, E. Clark, M. Ayers, W. F. Symmans, L. Pusztai, and K. J. Bloom The HER-2/neu Gene and Protein in Breast Cancer 2003: Biomarker and Target of Therapy Oncologist, August 1, 2003; 8(4): 307 - 325. [Abstract] [Full Text] [PDF]