HER family expression in egyptian breast cancer patients

Abstract EN

Objective : this study aimed to study the expression of HER 2, HER 3 and HER 4 members of HER family (c-erbB-2, c-erbB-3 and c-erbB-4, respectively) in Egyptian breast cancer patients, to correlate them to different prognostic markers: age, menopausal status, tumor size, histological grade, presence of introduce component, lymph node (LN) involvement, estrogen and progesterone receptors (ER and PR) status as well as to each other and to evaluate their clinical impact.

Material and Methods : this study included 49 female cancer breast patients with invasive duct carcinoma (IDC).

Their age ranged from 25 to 70 years with a mean of 48.4 years.

HER 2 and HER 3 were examined by both immunohistochemistry (IH) and reverse transcriptase polymerase chain reaction (RT-PCR) and HER 4 by RT-PCR only.

Patients were followed up for at least one year after the date of diagnosis for the development of either local recurrence or distant metastases.

Results : HER 2 expression was encountered in 79.5 % (39 / 49) by IH vs.

81.6 % (40 / 49) by RT-PCR, HER 3 in 46.9% (23 / 49) by IH vs.

67.3 % (33 / 49) by RT-PCR and HER 4 in 55.1 % (27 / 49) by RT-PCR.

No significant association was found between any HER family member on one side and neither age, menopausal status, tumor size nor histological grade on the other side.

A significant association was detected between: HER 2 expression and LN (p = 0.01) and HER 3 expression and presence of introduce component (p = 0.02).

A significant association was detected between HER 4 expression and both ER and PR (p = 0.001, p = 0.02).

An inverse association was encountered between HER 4 over expression and both LN and HER 2 over expression (p = 0.009, p = 0.003, respectively).

Follow up of 40 patients revealed that 32.5 % (13 / 40) developed recurrence.

In the 13 cases who developed recurrences, HER 2 was positive in 11, HER 3 in 10 and HER 4 in 9 vs.

23, 17 and 15, respectively in the 27 cases who didn’t develop recurrence.

Conclusions: Immunohistochemistry proved to be an efficient screening test for HER 2 and HER 3; molecular techniques (RT-PCR) should be restricted to negative IH cases.

HER 2 and HER 3 were associated with bad prognostic parameters while HER 4 could not be considered as one of the favorable factors till proved otherwise.