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High risk of recurrence for patients with breast cancer who have human epidermal growth factor receptor 2-positive, node-negative tumors 1 cm or smaller
Journal of Clinical Oncology, 11/06/09

Gonzalez-Angulo AM et al. – Patients with HER2-positive T1abN0M0 tumors have a significant risk of relapse and should be considered for systemic, anti-HER2, adjuvant therapy.

Methods

965 T1a,bN0M0 breast cancers diagnosed at our institution between 1990 and 2002 reviewed
Dedicated breast pathologists confirmed HER2 positivity if 3+ by immunohistochemistry or if it had ratio of 2.0 or greater by fluorescence in situ hybridization (FISH)
Patients who received adjuvant chemotherapy or trastuzumab were excluded
Kaplan-Meier product used to calculate recurrence-free survival (RFS) and distant recurrence–free survival (DRFS)
Cox proportional hazard models fit to determine associations between HER2 status and survival after adjustment for patient and disease characteristics
Additionally, 350 breast cancers from two other institutions used for validation

Results

10% of patients had HER2-positive tumors
Median follow-up of 74 months
72 recurrences
5-year RFS rates 77.1% and 93.7% in patients with HER2-positive and HER2-negative tumors
In multivariate analysis, patients with HER2-positive tumors had higher risks of recurrence and distant recurrence than those with HER2-negative tumors
Patients with HER2-positive tumors had 5.09 times the rate of recurrences and 7.81 times the rate of distant recurrences at 5 years compared with patients who had hormone receptor–positive tumors

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