Two histopathologically different diseases: Hormone receptor-positive and hormone receptor-negative tumors in HER2-positive breast cancer

Hee Jin Lee, In Ah Park, So Yeon Park, An Na Seo, Bora Lim, Yun Chai, In Hye Song, Na Eun Kim, Joo Young Kim, Jong Han Yu, Jin Hee Ahn, Gyungyub Gong

Research output: Contribution to journalArticlepeer-review

47 Scopus citations

Abstract

The clinical behavior of human epidermal growth factor 2 (HER2)-positive breast cancer, including pathologic complete response rate and pattern of relapse and metastasis, differs substantially according to hormone receptor (HR) status. We investigated various histopathologic features of HER2-positive breast cancer and their correlation with HR status. We retrospectively analyzed tumors of 450 HER2-positive breast cancer patients treated with chemotherapy and 1 year of trastuzumab. HR-/HER2+ tumors showed higher nuclear grade, less tubule formation, higher histologic grade, frequent apocrine features, diffuse and abundant lymphocytic infiltration, strong HER2 immunohistochemical staining (3+), higher average HER2 copy number and HER2/CEP17 ratio, the absence of HER2 genetic heterogeneity, and greater p53 expression than HR+/HER2+ tumors. An inverse correlation was observed between estrogen receptor or progesterone receptor Allred score and average HER2 copy number or HER2/CEP17 ratio. The percentage of ductal carcinoma in situ (DCIS) within the tumor was negatively correlated with ER Allred score, but positively correlated with average HER2 copy number and HER2/CEP17 ratio. Pathologic tumor size and DCIS percentage also showed a significant inverse correlation. Ratio of metastatic to total examined lymph node number was significantly correlated with average HER2 copy number and HER2/CEP17 ratio. High pT stage (hazard ratio, 2.370; p = 0.027), the presence of lymphovascular invasion (hazard ratio, 2.806; p = 0.005), and HR negativity (hazard ratio, 2.202; 1.074-4.513; p = 0.031) were found to be independent prognostic indicators of poor disease-free survival. In conclusion, HR+/HER2+ and HR-/HER2+ breast cancer showed distinct histopathologic features that may be relevant to their distinct clinical behavior.

Original languageEnglish
Pages (from-to)615-623
Number of pages9
JournalBreast Cancer Research and Treatment
Volume145
Issue number3
DOIs
StatePublished - Jun 2014

Keywords

  • Breast carcinoma
  • Gene amplification
  • HER2
  • Hormone receptor

Fingerprint

Dive into the research topics of 'Two histopathologically different diseases: Hormone receptor-positive and hormone receptor-negative tumors in HER2-positive breast cancer'. Together they form a unique fingerprint.

Cite this