PMID- 19884543
OWN - NLM
STAT- MEDLINE
DCOM- 20091223
LR  - 20220318
IS  - 1527-7755 (Electronic)
IS  - 0732-183X (Print)
IS  - 0732-183X (Linking)
VI  - 27
IP  - 34
DP  - 2009 Dec 1
TI  - High risk of recurrence for patients with breast cancer who have human epidermal 
      growth factor receptor 2-positive, node-negative tumors 1 cm or smaller.
PG  - 5700-6
LID - 10.1200/JCO.2009.23.2025 [doi]
AB  - PURPOSE: To evaluate the risk of recurrence in women diagnosed with T1a and T1b, 
      node-negative, human epidermal growth factor receptor 2 (HER2) -positive breast 
      cancer. METHODS: We reviewed 965 T1a,bN0M0 breast cancers diagnosed at our 
      institution between 1990 and 2002. Dedicated breast pathologists confirmed HER2 
      positivity if 3+ by immunohistochemistry or if it had a ratio of 2.0 or greater 
      by fluorescence in situ hybridization (FISH). Patients who received adjuvant 
      chemotherapy or trastuzumab were excluded. Kaplan-Meier product was used to 
      calculate recurrence-free survival (RFS) and distant recurrence-free survival 
      (DRFS). Cox proportional hazard models were fit to determine associations between 
      HER2 status and survival after adjustment for patient and disease 
      characteristics. Additionally, 350 breast cancers from two other institutions 
      were used for validation. RESULTS: Ten percent of patients had HER2-positive 
      tumors. At a median follow-up of 74 months, there were 72 recurrences. The 5-year 
      RFS rates were 77.1% and 93.7% in patients with HER2-positive and HER2-negative 
      tumors, respectively (P < .001). The 5-year DRFS rates were 86.4% and 97.2% in 
      patients with HER2-positive and HER2-negative tumors, respectively (P < .001). In 
      multivariate analysis, patients with HER2-positive tumors had higher risks of 
      recurrence (hazard ratio [HR], 2.68; 95% CI, 1.44 to 5.0; P = .002) and distant 
      recurrence (HR, 5.3; 95% CI, 2.23 to 12.62; P < .001) than those with 
      HER2-negative tumors. Patients with HER2-positive tumors had 5.09 times (95% CI, 
      2.56 to 10.14; P < .0001) the rate of recurrences and 7.81 times (95% CI, 3.17 to 
      19.22; P < .0001) the rate of distant recurrences at 5 years compared with 
      patients who had hormone receptor-positive tumors. CONCLUSION: Patients with 
      HER2-positive T1abN0M0 tumors have a significant risk of relapse and should be 
      considered for systemic, anti-HER2, adjuvant therapy.
FAU - Gonzalez-Angulo, Ana M
AU  - Gonzalez-Angulo AM
AD  - Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer 
      Center, Houston, TX 77030-4009, USA. agonzalez@mdanderson.org
FAU - Litton, Jennifer K
AU  - Litton JK
FAU - Broglio, Kristine R
AU  - Broglio KR
FAU - Meric-Bernstam, Funda
AU  - Meric-Bernstam F
FAU - Rakkhit, Ronjay
AU  - Rakkhit R
FAU - Cardoso, Fatima
AU  - Cardoso F
FAU - Peintinger, Florentia
AU  - Peintinger F
FAU - Hanrahan, Emer O
AU  - Hanrahan EO
FAU - Sahin, Aysegul
AU  - Sahin A
FAU - Guray, Merih
AU  - Guray M
FAU - Larsimont, Denis
AU  - Larsimont D
FAU - Feoli, Francesco
AU  - Feoli F
FAU - Stranzl, Heidi
AU  - Stranzl H
FAU - Buchholz, Thomas A
AU  - Buchholz TA
FAU - Valero, Vicente
AU  - Valero V
FAU - Theriault, Richard
AU  - Theriault R
FAU - Piccart-Gebhart, Martine
AU  - Piccart-Gebhart M
FAU - Ravdin, Peter M
AU  - Ravdin PM
FAU - Berry, Donald A
AU  - Berry DA
FAU - Hortobagyi, Gabriel N
AU  - Hortobagyi GN
LA  - eng
GR  - K23 CA121994/CA/NCI NIH HHS/United States
GR  - 1K23 CA121994-01/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20091102
PL  - United States
TA  - J Clin Oncol
JT  - Journal of clinical oncology : official journal of the American Society of 
      Clinical Oncology
JID - 8309333
RN  - 0 (Receptors, Estrogen)
RN  - 0 (Receptors, Progesterone)
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
SB  - IM
CIN - J Clin Oncol. 2009 Dec 1;27(34):5671-3. PMID: 19884535
CIN - J Clin Oncol. 2010 Jun 10;28(17):e281; author reply e282-3. PMID: 20368535
CIN - J Clin Oncol. 2010 Jun 10;28(17):e279-80; author reply e282-3. PMID: 20406920
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Breast Neoplasms/*chemistry/*pathology
MH  - Disease-Free Survival
MH  - Female
MH  - Humans
MH  - Lymphatic Metastasis
MH  - Middle Aged
MH  - Neoplasm Metastasis
MH  - Neoplasm Recurrence, Local
MH  - Prognosis
MH  - Receptor, ErbB-2/*analysis/*metabolism
MH  - Receptors, Estrogen/analysis/metabolism
MH  - Receptors, Progesterone/analysis/metabolism
MH  - Risk Factors
PMC - PMC2792998
COIS- Authors' disclosures of potential conflicts of interest and author contributions 
      are found at the end of this article.
EDAT- 2009/11/04 06:00
MHDA- 2009/12/24 06:00
PMCR- 2010/12/01
CRDT- 2009/11/04 06:00
PHST- 2009/11/04 06:00 [entrez]
PHST- 2009/11/04 06:00 [pubmed]
PHST- 2009/12/24 06:00 [medline]
PHST- 2010/12/01 00:00 [pmc-release]
AID - JCO.2009.23.2025 [pii]
AID - 32025 [pii]
AID - 10.1200/JCO.2009.23.2025 [doi]
PST - ppublish
SO  - J Clin Oncol. 2009 Dec 1;27(34):5700-6. doi: 10.1200/JCO.2009.23.2025. Epub 2009 
      Nov 2.