Pathologic findings from the national surgical adjuvant breast and bowel project

Prognostic significance of erbE-2 protein overexpression in primary breast cancer

Soonmyoung Paik, Rachel Hazan, Edwin R. Fisher, Richard E. Sass, Bernard Fisher, Carol Redmond, Joseph Schlessinger, Marc E. Lippman, C. Richter King

Research output: Contribution to journalArticle

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Abstract

In order to investigate the prognostic significance of erbB-2 overexpression, immunohistochemical staining for the erbB-2 protein was performed on sections from paraffin blocks of 292 primary invasive breast cancers obtained from women enrolled in the National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol B-06. Positive reaction indicative of erbB-2 overexpression was observed on tumor cells in 62 (21%) samples. Women whose cancers were judged to have erbB-2 overexpression had a significantly worse overall survival (P = .0012) with twice the mortality rate of women without detectable erbB-2 expression. No statistically significant effect was evident for diseasefree survival (P = .22). In multivariate analysis, detection of erbB-2 overexpression was the second most predictive independent variable for survival after nodal status. Overexpression of erbB-2 was more common among tumors of poor nuclear grade (29%) than those of good nuclear grade (12%). The association of ertB-2 overexpression with decreased survival was evident only among women with tumors of good nuclear grade. In this subgroup, erbB-2 overexpression was associated with an approximately fivefold increase in mortality rate (P = .00001). The combined predictive value of ertbB-2 overexpression and nuclear grade was evident regardless of their lymph node status. These results provide evidence that detection of erbB-2 overexpression may be an independent prognostic variable for patient survival. Moreover, when combined with evaluation of nuclear grade, it may be possible to use immunostaining for erbB-2 protein to identify patients at increased risk from within a relatively low-risk group.

Original languageEnglish (US)
Pages (from-to)103-112
Number of pages10
JournalJournal of Clinical Oncology
Volume8
Issue number1
StatePublished - 1990
Externally publishedYes

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Breast
Breast Neoplasms
Survival
Proteins
Neoplasms
Mortality
Paraffin
Multivariate Analysis
Lymph Nodes
Staining and Labeling

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Pathologic findings from the national surgical adjuvant breast and bowel project : Prognostic significance of erbE-2 protein overexpression in primary breast cancer. / Paik, Soonmyoung; Hazan, Rachel; Fisher, Edwin R.; Sass, Richard E.; Fisher, Bernard; Redmond, Carol; Schlessinger, Joseph; Lippman, Marc E.; King, C. Richter.

In: Journal of Clinical Oncology, Vol. 8, No. 1, 1990, p. 103-112.

Research output: Contribution to journalArticle

Paik, Soonmyoung ; Hazan, Rachel ; Fisher, Edwin R. ; Sass, Richard E. ; Fisher, Bernard ; Redmond, Carol ; Schlessinger, Joseph ; Lippman, Marc E. ; King, C. Richter. / Pathologic findings from the national surgical adjuvant breast and bowel project : Prognostic significance of erbE-2 protein overexpression in primary breast cancer. In: Journal of Clinical Oncology. 1990 ; Vol. 8, No. 1. pp. 103-112.
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abstract = "In order to investigate the prognostic significance of erbB-2 overexpression, immunohistochemical staining for the erbB-2 protein was performed on sections from paraffin blocks of 292 primary invasive breast cancers obtained from women enrolled in the National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol B-06. Positive reaction indicative of erbB-2 overexpression was observed on tumor cells in 62 (21{\%}) samples. Women whose cancers were judged to have erbB-2 overexpression had a significantly worse overall survival (P = .0012) with twice the mortality rate of women without detectable erbB-2 expression. No statistically significant effect was evident for diseasefree survival (P = .22). In multivariate analysis, detection of erbB-2 overexpression was the second most predictive independent variable for survival after nodal status. Overexpression of erbB-2 was more common among tumors of poor nuclear grade (29{\%}) than those of good nuclear grade (12{\%}). The association of ertB-2 overexpression with decreased survival was evident only among women with tumors of good nuclear grade. In this subgroup, erbB-2 overexpression was associated with an approximately fivefold increase in mortality rate (P = .00001). The combined predictive value of ertbB-2 overexpression and nuclear grade was evident regardless of their lymph node status. These results provide evidence that detection of erbB-2 overexpression may be an independent prognostic variable for patient survival. Moreover, when combined with evaluation of nuclear grade, it may be possible to use immunostaining for erbB-2 protein to identify patients at increased risk from within a relatively low-risk group.",
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