Clinicopathological characteristics and prognostic factors of breast cancer with estrogen- and progesterone-receptor negative and HER-2 overexpression

OBJECTIVE: To evaluate the clinicopathological characteristics and prognosis of breast cancer with estrogen- and progesterone-receptor negative (ER-/PR-) and HER-2 overexpression (HER+++) in a Chinese population. METHODS: The data of patients with ER-/PR- and HER+++ breast cancer treated in our hospital from March 1999 to December 2004 were retrospectively reviewed. The influence of clinicopathological characteristics and molecular markers on the survival was analyzed. RESULTS: A total of 111 breast cancer patients with ER and PR negative but HER+++ were identified, accounting for 4.9% of all the breast cancer patients treated during the same period. There were 25 cases (22.5%) in stage I, 44 (39.6%) in stage II and 36 (32.4%) in stage III, respectively, with a median age of 49 years. Axillary lymph node metastasis was found in 54 cases. The 5-year disease free survival (DFS) and overall survival rates (OS) were 70.7% and 73.1%, respectively. Univariate analysis showed that lymph node status, primary tumor size and pathological stage were prognosis-related factors influencing the DFS and OS. However, by multivariate analysis, only primary tumor size and lymph node status were independent factors influencing survival. CONCLUSION: The breast cancer with estrogen- and progesterone-receptor negative but HER-2 overexpression is a particular subtype of breast cancers, with unfavorable clinicopathological characteristics and poor survival. Lymph node status and primary tumor size are two independent prognostic factors.