Clinical Characteristics And Prognostic Factors Of Female Breast Cancer Patients With HER-2 Overexpression

ObjectiveTo analyse the clinical characteristics and potential prognostic factors of the breast cancer patients with HER-2 Overexpression.MethodsHER-2 Overexpression breast cancer patients from Mar, 1999 to Des, 2004 in our hospital were retrospectively reviewed. Clinical characteristics, survival and prognostic factors were analyzed by SPSS 13.0 statistic software.ResultsMedian age of all 371 patients is 48 years, 61.2% of the patients are premenopause; more than 90% cases are infitrating ductal carcinoma and histologic grade 2 or 3; tumor size is bigger than 2cm in 62.8% cases, 51.0% have positive lymph node, 52.8% have negative ER and PR status. In the 259 patients whose therapy data were available, 88% received adjuvant chemotherapy after surgery. Adjuvant hormonal therapy was given to 53.3% patients. 68.3% cases were disease-free survived till Apr 10th 2007. There are 65 loco-regional or distant relapse and 4 secondary malignancies. 5 years DFS and OS is 68.0% and 78.0% respectively. By the single-variant's Kaplan-Merier analysis, Patient age＜35, tumor size＞2cm, axillary nodal status positive, lymphatic/ascular invasion and proliferating cell nuclear antigen (+++) are associated with poor prognosis. Tumor histologic grade does not have the prognostic significance. Adjuvant hormonal therapy and sufficient chemotherapy (4-6cycles) significantly improves DFS and OS. But there is no significant difference between the patients with and without the adjuvant radiotherapy. Adjuvant chemotherapy does not effect patient's survival. The reasons may be the unsuitable chemotherapy regimens, and insufficient dose intensity. Heceptin improves DFS and OS but not significantly. After the multi-variants' Cox regression analysis, we found adjuvant endocrine therapy, axillary nodal status, lymphatic/ascular invasion and proliferating cell nuclear antigen were the independent prognostic factors.ConclusionsBreast cancer patients with HER-2 Overexpression have a poorer prognosis if patients are younger than 35 years and/or with tumor size＞2cm, axillary nodal status positive, lymphatic/ascular invasion and proliferating cell nuclear antigen (+++). Adjuvant hormonal therapy and sufficient chemotherapy (4-6cycles) will improve survival. Limited with the insufficient patient s' quantity and follow-up time, adjuvant chemotherapy and Heceptin don't effect patient's survival. There still need further investigation and follow-up.