Background: With the advent of screening mammography more breast cancer will be detected at an earlier stage, apparently confined to the breast with no nodal involvement. However, 30% of these will recur due to micrometastases present at the time of diagnosis. Chemotherapy and tamoxifen have been shown to improve disease-free survival in axillary node-negative patients but not overall survival. In the search for a useful predictor of breast cancer recurrence the relationship between c-erbB-2 expression and recurrence and survival was examined.
Methods: Eighty-eight axillary node-negative breast cancer patients were followed up for at least 5 years.
Results: There was a significant relationship between c-erbB-2 expression and both tumour recurrence (P<0.001) and poorer survival (P=0.003). In a Cox multiple regression analysis, c-erbB-2 staining remained the only significant prognostic variable for recurrence (P=0.002) and survival (P=0.032). Tumour recurrence in c-erbB-2-positive cases tended to occur early in the course of follow up and was associated with poorer survival.
Conclusion: C-erbB-2 was found to be a useful prognostic indicator for early recurrence and poorer survival in axillary node-negative breast cancer patients.