Open AccessThe Relationships between HER 2 Overexpression and DCIS Characteristics
Author(s) -
Di Cesare Pamela,
Pavesi Lorenzo,
Villani Laura,
Battaglia Andrea,
Da Prada Gian Antonio,
Riccardi Alberto,
Frascaroli Mara
Publication year - 2016
Publication title -
the breast journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.533
H-Index - 72
eISSN - 1524-4741
pISSN - 1075-122X
DOI - 10.1111/tbj.12735
Subject(s) - medicine , ductal carcinoma , immunohistochemistry , breast cancer , estrogen receptor , human epidermal growth factor receptor 2 , progesterone receptor , oncology , field cancerization , her2 negative , cancer , pathology , metastatic breast cancer
The aim of this study was to demonstrate the correlation between human epidermal growth factor receptor 2 ( HER 2) overexpression and some poor prognosis factors in patients affected by ductal carcinoma in situ ( DCIS ). We evaluated 48 cases of DCIS , divided into two groups according to HER 2 amplification status. Nuclear grade and “cancerization of lobules” were determined within primary DCIS and Ki67, estrogen receptor ( ER ), PR , and HER 2 expression was established using immunohistochemistry. The histopathological variables in HER 2‐positive and in HER 2‐negative patients were compared to determine the recurrence risk. We also considered the median age at the time of surgery according to HER 2 status. There were 11 recurrences (23%), 6 DCIS (55%), and 5 invasive cancer (45%). In an 8‐year‐long median follow‐up, we hypothesized high risk of recurrence in HER 2‐positive DCIS . Patients with HER 2‐positive DCIS were younger than HER 2‐negative ones (p = 0.002). HER 2‐positive DCIS was also related to histopathological predictors of recurrence such as high nuclear grade (p < 0.001), high Ki67 expression (p = 0.003), low ER and PgR levels (p < 0.001), and the presence of “cancerization of lobules” (p < 0.049). Our trial suggests that HER 2 amplification in primary DCIS is identified more frequently in younger patients and hypothesizes high risk of recurrence in HER 2‐positive DCIS related to histopathological predictors of overall relapse as high nuclear grade, high Ki67 expression, low ER and PgR levels, and the presence of “cancerization of lobules.” In HER 2‐positive DCIS , other variables of recurrence risk are compared to HER 2‐negative lesions, without statistical significance. Our results show that HER 2 testing might suggest clinicians the optimal treatment of patients with DCIS .