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

Background: 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 fur a useful predictor of breast cancer recurrence the relationship between c-erDB-2 expression and recurrence and survival was examined. Methods: Eighty-eight axillary node-negative breast cancer patients were followed up for at least 5 years. Results: 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. Conclusion: C-erbB-2 was found to be a useful prognostic indicator for early recurrence and poorer survival in axillary node-negative breast cancer patients.