Influence of Neoadjuvant Chemotherapy on HER2/neu Status in Invasive Breast Cancer |
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| Authors: | Peifeng Li Tantan Liu Yingmei Wang Shuai Shao Weichen Zhang Yang Lv Jun Yi Zhe Wang |
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| Affiliation: | 1. State Key Laboratory of Cancer Biology, Department of Pathology, Xijing Hospital and School of Basic Medicine, Fourth Military Medical University, Xi''an, P.R. China;2. Department of Pathology, General Hospital of Jinan Military Command, Jinan, P.R. China;3. Department of Vascular and Endocrine Surgery, Xijing Hospital, Fourth Military Medical University, Xi''an, P.R. China;1. Service de Pathologie, Hôpital Saint-Louis, AP-HP, Paris, France;2. UPFR Anatomie et Cytologie Pathologiques, CHU Andrainjato, Fianarantsoa, Madagascar;3. Service de Recherches en Hémato-immunologie, CEA, Hôpital Saint-Louis, Paris, France;4. Université Paris Diderot, UMR E_5, Institut Universitaire d''Hématologie, Paris, France;5. Service d''Oncologie Médicale, Hôpital Saint-Louis, AP-HP, Paris, France;6. Service d''Urologie, Hôpital Saint-Louis, AP-HP, Paris, France;7. Université Paris Diderot, Inserm, UMR_S1165, Institut Universitaire d''Hématologie, Paris, France;1. Division of Urology, Department of Surgery, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA;2. Department of Surgery, Center for Surgery and Public Health, Brigham and Women''s Hospital, Boston, MA;3. Department of Urology, Marien Hospital, Ruhr-University Bochum, Herne, Germany;4. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany;5. Division of Urologic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA;1. Department of Otolaryngology, Gyeongsang National University, Jinju, South Korea;2. Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea;3. Department of Otorhinolaryngology–Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea;1. Department of Mathematics, University of the Aegean, Karlovassi, Samos, GR-832 00, Greece;2. Department of Economics, National and Kapodistrian University of Athens, Athens, GR-105 59, Greece;3. Department of Mathematics, University of Texas at Austin, Austin, TX 7812, USA |
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| Abstract: | IntroductionReliably estimating HER2/neu expression in breast cancer is important for predicting patient prognosis and optimizing adjuvant therapeutic strategies. In this retrospective cohort study, effects of NAC on HER2/neu status in invasive breast cancer were evaluated, and the related factors were analyzed.Patients and MethodsOne hundred thirty-one patients with primary breast cancer were treated with anthracycline- and/or taxane-based NAC. HER2/neu status was evaluated by IHC on core needle biopsies of primary tumors before NAC and surgical resection specimens of post-NAC residual breast cancers or tumor-positive axillary lymph nodes. Thirty-two pairs of specimens with discordant HER2/neu IHC scores were analyzed by fluorescence in situ hybridization (FISH).ResultsA significant difference in HER2/neu status by IHC between core needle biopsies and surgical resection specimens in patients receiving NAC was observed. After NAC, 23.4% (29 of 124) of tumors showed downregulated HER2/neu expression by IHC. Alterations of HER2/neu IHC scores did not significantly correlate with tumor subtype, pathologic response to NAC, adjuvant regimen, or time interval from the last chemotherapy to surgery. HER2/neu protein overexpression level was associated with favorable pathologic response to anthracycline and taxane-based chemotherapy. However, tumors with altered HER2/neu IHC scores after NAC revealed stable HER2/neu gene amplification/nonamplification by FISH analysis.ConclusionNeoadjuvant chemotherapy for breast carcinoma resulted in the HER2/neu status alteration by IHC, but they have stable gene amplification status by FISH. HER2/neu protein overexpression indicated greater sensitivity to neoadjuvant anthracycline- and taxane-based chemotherapy. Thus, retesting HER2/neu IHC status in residual tumors after NAC should be considered in order to optimize adjuvant systemic therapy. |
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