| Title: |
Clinicopathologic Significance of the Intratumoral Heterogeneity of HER2 Gene Amplification in HER2-Positive Breast Cancer Patients Treated With Adjuvant Trastuzumab. |
| Authors: |
Hee Jin Lee, Joo Young Kim, So Yeon Park, In Ah Park, In Hye Song, Jong Han Yu, Jin-Hee Ahn, Gyungyub Gong, Lee, Hee Jin, Kim, Joo Young, Park, So Yeon, Park, In Ah, Song, In Hye, Yu, Jong Han, Ahn, Jin-Hee, Gong, Gyungyub |
| Source: |
American Journal of Clinical Pathology; Oct2015, Vol. 144 Issue 4, p570-578, 9p, 3 Charts, 2 Graphs |
| Abstract: |
Objectives: Although intratumoral heterogeneity of human epidermal growth factor receptor 2 (HER2) gene amplification has been associated with a poor prognosis for primary HER2-positive breast cancer and metastatic HER2-positive breast cancer treated with trastuzumab, the clinicopathologic significance in a setting involving trastuzumab treatment as an adjuvant treatment has not been studied in patients. Methods: We retrospectively investigated 443 patients with HER2-positive breast cancer treated with surgery, adjuvant chemotherapy, and 1 year of trastuzumab. Three areas that showed different levels of HER2 protein expression were chosen, and silver in situ hybridization was performed. Results: HER2 regional and genetic heterogeneity was found in 6.2% and 6.8% of tumors, respectively. Both types of heterogeneity were significantly associated with hormone receptor positivity, HER2 immunohistochemistry score of 2+, a low level of HER2 gene amplification, and absence of an extensive intraductal component. Genetic heterogeneity also showed strong correlation with a lower histologic grade. In the hormone receptor-positive group, the regional heterogeneity affected disease-free survival of patients (hazard ratio, 4.869; 95% confidence interval, 1.424-16.646; P = .005), whereas genetic heterogeneity did not. Conclusions: Evaluation of intratumoral heterogeneity, especially in cases with hormone receptor positivity, may be valuable for assessing the prognosis of HER2-positive patients anticipating treatment with adjuvant systemic therapy and trastuzumab. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
