Review Article

Medical Oncology

, Volume 29, Issue 4, pp 2586-2593

Role of HER2-neu as a prognostic factor for survival and relapse in pT1a–bN0M0 breast cancer: a systematic review of the literature with a pooled-analysis

  • F. PetrelliAffiliated withMedical Oncology Unit, Oncology Department, Azienda Ospedaliera Treviglio-Caravaggio Email author 
  • , S. BarniAffiliated withMedical Oncology Unit, Oncology Department, Azienda Ospedaliera Treviglio-Caravaggio

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Abstract

High levels of human epidermal growth receptor 2 (HER2) expression are associated with recurrence and death in breast cancer (BC) patients. We have performed a systematic review and meta-analysis in order to evaluate the prognosis for HER2+ pT1a–bN0M0 BC patients. A search of PubMed and Embase was performed. Studies were included if they reported hazard ratios (HRs) with a 95% confidence interval (CI) for multivariate analyses of relapse or survival in pT1a–bN0M0, HER2+ BC patients treated with surgery and chemotherapy and/or endocrine therapy, but not with trastuzumab. A total of 764 patients from seven studies were included in the meta-analysis. In the pooled analysis, HER2 had a detrimental effect on relapse-free (HR 4.68, 95% CI 3.05–7.18; p < 0.00001) and distant relapse-free survival, with a HR of 5.6 (95% CI 2.65–11.85; p < 0.00001). HER2+ status was also linked to increased risk of death (HR 3.4, 95% CI 0.86–13.41; p = 0.08) and worst BC-specific survival (HR 2.61, 95% CI 1.51–4.51; p = 0.0006), but these data were presented in few studies. HER2+ pT1a–bN0M0 BC is associated with a dismal prognosis. In these patients, HER2 has to be taken into account when deciding on adjuvant therapy, and trastuzumab should be considered.

Keywords

pT1a–bN0M0 HER2 positive Breast cancer Relapse Survival Prognosis