Epidemiology

Breast Cancer Research and Treatment

, Volume 113, Issue 1, pp 181-187

Axillary lymph node status of operable breast cancers by combined steroid receptor and HER-2 status: triple positive tumours are more likely lymph node positive

  • Ben Van CalsterAffiliated withMultidisciplinary Breast Centre, UZ Leuven
  • , Isabelle Vanden BemptAffiliated withMultidisciplinary Breast Centre, UZ Leuven
  • , Maria DrijkoningenAffiliated withMultidisciplinary Breast Centre, UZ Leuven
  • , Nathalie PochetAffiliated withMultidisciplinary Breast Centre, UZ Leuven
  • , Jiqiu ChengAffiliated withMultidisciplinary Breast Centre, UZ Leuven
  • , Sabine Van HuffelAffiliated withMultidisciplinary Breast Centre, UZ Leuven
  • , Wouter HendrickxAffiliated withMultidisciplinary Breast Centre, UZ Leuven
  • , Julie DecockAffiliated withMultidisciplinary Breast Centre, UZ Leuven
  • , Huei-Jean HuangAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Karin LeunenAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Frederic AmantAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Patrick BertelootAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Robert ParidaensAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Hans WildiersAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Erik Van LimbergenAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Caroline WeltensAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Dirk TimmermanAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Toon Van GorpAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Ann SmeetsAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Walter Van den BogaertAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Ignace VergoteAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Marie-Rose ChristiaensAffiliated withMultidisciplinary Breast Centre, UZ Leuven
    • , Patrick NevenAffiliated withMultidisciplinary Breast Centre, UZ Leuven Email author 

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Aims To examine the frequency of axillary lymph node (ALN) invasion of operable breast cancers by their combined oestrogen receptor (ER), progesterone receptor (PR) and HER-2 status. Methods 2227 recently operated cases in one centre were retrieved from the Multidisciplinary Breast Centre database and stratified according to their combined immunohistochemical (IHC) expression of ER/PR/HER-2 status. An equivocal HER-2 status was further analysed by Fluorescence in situ Hybridisation (FISH). The following 6 groups were considered: ERPRHER-2 (NNN; triple negative), ERPRHER-2+ (NNP), ER+PRHER-2 (PNN), ER+PRHER-2+ (PNP), ER+PR+HER-2(PPN), ER+PR+HER-2+ (PPP; triple positive). For ALN, the following variables were tested in uni- and multivariate models: age at diagnosis (years), tumour size (mm), tumour grade, ER, PR, HER-2 and the combined steroid receptor and HER-2 status. Likelihood ratio χ2-tests were used for univariate analysis and logistic regression for multivariate analysis. Results Triple positive tumours had a higher likelihood of being ALN positive than others (56.2% versus 35.7%; P < 0.0001). Univariate logistic regression also withheld age, size, grade and HER-2 as predictors of ALN involvement. Final multivariate logistic regression revealed age, size, grade and PPP versus non-PPP to be independent predictors of ALN involvement; the odds ratio (OR) and 95% CI for PPP versus non-PPP tumours was 2.169 (1.490–3.156). Conclusion Our data provide insight into the natural history of triple positive breast carcinomas. Such tumours are more likely ALN positive than those with another steroid receptor and HER-2 status. How these findings correlate with breast cancer prognosis remains to be investigated.

Keywords

HER-2 Steroid receptors Lymph node Breast cancer