The prognostic significance of pathological features in Her-2 overexpressing breast carcinomas: A single institution experience in southern Tunisia

Article type: Research Article

Authors: Charfi, Slim^{a; *} | Toumi, Nabil^b | Triki, Sana^b | Kallel, Rim^a | Kebaïli, Sahbi^c | Chaabane, Kais^c | Khabir, Abdelmajid^a | Daoud, Jamel^d | Frikha, Mounir^b | Boudawara, Tahya Sellami^a

Affiliations: [a] Department of Pathology, CHU Habib Bourguiba, Sfax, Tunisia | [b] Department of Medical Oncology, CHU Habib Bourguiba, Sfax, Tunisia | [c] Department of Gynecology, CHU Hedi Chaker, Sfax, Tunisia | [d] Department of Radiotherapy, CHU Habib Bourguiba, Sfax, Tunisia

Correspondence: [*] Corresponding author: Slim Charfi, Laboratoire d'anatomie et de cytologie pathologiques, CHU Habib Bourguiba, Route ElAin Km 0,5. CP 3029 Sfax, Tunisia. Tel.: +216 98 972 756; Fax: +216 74 243 427; E-mail:charfislim@gmail.com

Abstract: 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.

Keywords: Breast cancer, HER-2, pathology, prognosis, survival

DOI: 10.3233/BD-150414

Journal: Breast Disease, vol. 35, no. 4, pp. 233-239, 2015