BACKGROUND: Breast cancer is the most frequent malignant neoplasm
affecting Tunisian women. It represents 25 to 35% of all female
cancers. There is no published study about the features of Her-2
overexpressing breast carcinomas in North African women.
OBJECTIVE: The aim of this study is to assess the prognostic significance
of pathological features in a cohort of a Her-2 overexpressing breast
carcinoma originating from the region of south Tunisia.
METHODS:
This study investigated a series of 100 patients followed from
January 2006 to December 2011 for a Her-2 positive invasive breast
carcinoma. Pathological features included in this study were: histological
type, histological grade, tumor size, vascular invasion, perineural
invasion, mitotic index, lymph nodes stage, positive lymph node capsular
effraction, inflammatory infiltrates, nipple involvement and hormone
receptors status.
RESULTS: Multivariate analysis showed that pT stage, pN stage, capsular
effraction, vascular invasion, perineural invasion and Nipple involvement
were independent prognostic factors for overall survival and disease free
survival in patients free from distant metastasis at diagnosis. For patients
with synchronous metastasis, there is no independent pathologic prognostic
factor for survival.
CONCLUSIONS: Our study demonstrates that pathological features are
important prognostic factors for non metastatic Her-2 overexpressing breast
carcinomas. This supports the idea that HER2-positive disease is a
heterogeneous entity. We believe that these findings reinforce the need to
identify molecular predictors of benefit and resistance to anti-Her-2 based
therapies.
