PROGNOSTIC SIGNIFICANCE OF c‐erbB‐2 ONCOGENE IN AXILLARY NODE‐NEGATIVE BREAST CANCER

Abstract

With the advent of screening mammography more breast cancer will be detected at an earlier stage, apparently confined to the breast with no nodal involvement. However, 30% of these will recur due to micrometastases present at the time of diagnosis. Chemotherapy and tamoxifen have been shown to improve disease-free survival in axillary node-negative patients but not overall survival. In the search for a useful predictor of breast cancer recurrence the relationship between c-erbB-2 expression and recurrence and survival was examined. Eighty-eight axillary node-negative breast cancer patients were followed up for at least 5 years. There was a significant relationship between c-erbB-2 expression and both tumour recurrence (P<0.001) and poorer survival (P=0.003). In a Cox multiple regression analysis, c-erbB-2 staining remained the only significant prognostic variable for recurrence (P=0.002) and survival (P=0.032). Tumour recurrence in c-erbB-2-positive cases tended to occur early in the course of follow up and was associated with poorer survival. C-erbB-2 was found to be a useful prognostic indicator for early recurrence and poorer survival in axillary node-negative breast cancer patients.