Retrospektive Analyse der klinischen und histologischen Daten bei Patientinnen der Klinik für Gynäkologie, gynäkologische Endokrinologie und Onkologie mit Erstdiagnose eines HER2/neu positiven lokalisierten Mammakarzinoms
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The aim of this study was to present the clinical and histological data of patients with HER2/neu positive breast cancer and HER2/neu IHC2+/FISH negative cancer at the Breast Centre of Marburg University Hospital and to set it in the context of already published study results. This trial included patients who were first diagnosed between 2004 and 2020. Using data documented at the hospital, 310 patients were retrospectively identified and analysed for the HER2/neu positive cohort and 200 patients for the HER2/neu IHC2+/FISH negative cohort. This survey investigated the development of the parameters survival, age at diagnosis, TNM stage, grading, recurrence and therapy.
The 10-year overall survival rate for localised HER2/neu positive and HER2/neu IHC2+/FISH negative carcinomas was 78.9% and 74.3%. The overall survival of the two cohorts shows no significant difference. The improvement in the 10-year survival rate in patients with HER2/neu positive tumours who received trastuzumab compared to patients who did not receive trastuzumab (as it was not approved at the time) is consistent with international study results. Using the log-rank test, tumour stage T4, lymph node involvement and the presence of metastases were identified as statistically relevant factors influencing survival in HER2/neu positive breast cancer.
Regarding tumours with HER2/neu IHC2+/FISH negative findings, it was found that tumour size generally has an influence on survival and, as in HER2/neu positive patients, lymph node involvement and the presence of metastases are important as well.
Furthermore, the analysis showed that patients with HER2/neu positive breast cancer developed the disease at an average age of under 60 and patients with HER2/neu ICH2+/FISH negative tumours at an average age of under 65. In both cohorts, the tumours were initially diagnosed at low TNM stages, which can also be attributed to the expansion of mammography screening.
Over the past 25 years, new HER2/neu-targeted treatment methods have been approved for this group, which have improved the prognosis and survival. The use of targeted therapies, particularly trastuzumab, against the HER2/neu-receptor increased at the beginning of the observation period, as trastuzumab was approved in the EU and used early in Marburg. This has significantly improved the prognosis for HER2/neu positive breast cancer in the real world setting. Other substances targeting HER2/neu were introduced during the observation period, but their impact on the overall survival of patients will be evaluated in future analyses.
In conclusion, this dissertation supports the known study results regarding HER2/neu positive carcinomas, whereas the selected cohort of patients with HER2/neu IHC2+/FISH negative tumours may encourage further investigation, as there are few comparison groups in literature and further exploration of this subgroup may yield new findings. Future analyses should also include patients with HER2/neu IHC1+/FISH negative carcinoma to enhance comparability with studies investigating HER2/neu-low breast cancer.
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This item has been published with the following license: In Copyright