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Increased Likelihood of Mastectomy in Human

Epidermal Growth Factor Receptor 2-positive

uctal !arcinoma In "itu

Oleh

Dr. Mahendra

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HUMAN EPIDERMAL GROWTH factor receptor2(HER2neu) ! o"ere#pre!!e$ n appro#%atel& 'to 2 per cent of n"a!"e *rea!t carcno%a!+

Patent! ,th HER2neu-po!t"e n"a!"ecarcno%a ten$ to ha"e %ore $.u!e $!ea!e/lar0er tu%or!/ h0her 0ra$e le-!on!/ an$ %orea00re!!"e tu%or *eha"or nclu$n0 h0herrecurrence2/ 1 an$ poorer !ur""al+

3o%e lterature report! that HER2neu-po!t"eD4I3 ! %ore l5el& to *e h0h 0ra$e an$ %orel5el& to ha"e foc of %cron"a!on+

Introduction

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3%lar to n"a!"e $!ea!e/ %a!tecto%& an$lu%p-ecto%& ,th ra$aton *oth o.er 0oo$local control+

3tu$e! ha"e !ho,n that %ultfocalt& ! ann$epen$ent r!5 factor for the $e"elop%entof local recurrence after *rea!t-con!er"n0!ur0er& for D4I3'1 an$ that patent! ,th

%ultfocal D4I3 are three t%e! %ore l5el& toun$er0o %a!tecto%& than lu%pecto%&+

Introduction

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Other factor! foun$ to ncrea!e the%a!tecto%& rate n D4I3 are &oun0er a0e/h0her 0ra$e/ an$ lar0er tu%or!+

 Th! !tu$&6! o*7ect"e ! to n"e!t0ate thecorrelaton *e-t,een HER2neu-po!t"e !tatu!an$ %ore $.u!e D4I3 *& co%parn0preoperat"e %a0n0/ tu%or !8e/ an$ rate of

%a!tecto%& of HER2neu-po!t"e "er!u!-ne0at"e patent!+

Introduction

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Data ,ere 0athere$ on all patent!un$er0on0 *rea!t !ur0er& at the Un"er!t& of4alforna/ 3an De0o fro% 22 to 2''/ We

9uere$ th! $ata*a!e for all patent! ,th

D4I3+

E#clu!on crtera ,ere un5no,n HER2neu!tatu! an$ n"a!"e carcno%a on :nal pa-

tholo0&+

Pr%ar& n$epen$ent "ara*le ,a! HER2neu!tatu!+

Methods

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Methods

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4h-!9uare$ anal&!e! ,ere perfor%e$ co%parn0$e-%o0raphc nfor%aton an$ outco%e! *et,eenHER2neu-po!t"e an$ -ne0at"e patent! a! ,ella! %a!tecto%& an$ lu%pecto%& patent!+

A !n0le *rea!t ra$olo0!t ,ho ,a! *ln$e$ to theHER2neu !tatu! of the patent! re"e,e$ all%a0n0

Mult"arate anal&!e! ,ere then perfor%e$ tocontrol for co"arate! $eter%nn0 o$$! rato of

%a!tecto%&/ controlln0 for a0e/ race/ an$%artal !tatu!+

Patholo0& ,a! re"e,e$ for :nal !8e of thele!on+

Methods

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 There ,ere ; total patent! ,th D4I3 treate$

*et,een 22 an$ 2''+ T,o hun$re$ t,ent&-e0ht ca!e! ,ere e#clu$e$ for

un5no,n HER2neu !tatu!< '' patent! ('2 ca!e!) ,ere e#clu$e$ for n"a!"e

cancer on :nal patholo0&+ Thrt&-t,o of the!e ';; ca!e! ,ere HER2neu-

po!t"e ('=>)+ ?ft&-three total patent! (12>) un$er,ent

%a!tecto%&+ HER2neu-po!t"e patent! ten$ to *e &oun0er than

HER2neu-ne0at"e/ *ut th! ! not !0n:cant (P +22)< there ! no !0n:cant $.erence n race (P

+;=)+

Results

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HER2neu-po!t"e patent! ha"e !0n:cantl&h0her 0ra$e D4I3 (@+> are h0h 0ra$e "!12+@> of HER2neu-ne0at"e pa-tent!/ P B+')+

HER2neu-ne0at"e $!ea!e ! @ per cent ERCPR-po!t"e/ ,herea! HER2neu-po!t"e $!-ea!e !onl& = per cent ERCPR-po!t"e (P B +')+

 There ! no !0n:cant $.erence n a0e/ race/ or

%artal !tatu! *et,een patent! ,ho un$er0o%a!tecto%& or lu%p-ecto%&+ Patent! ,houn$er0o %a!tecto%& ha"e h0her 0ra$e D4I3an$ are %ore often ERCPR-ne0at"e+

Results

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 Ta*le 1 pre!ent! le!on !8e on %a0n0/%a!tecto%& rate/ an$ actual !8e on :nalpatholo0&+

Results

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 The re!ult! of th! !tu$& n$cate that HER2neu-po!t"e D4I3

le!on! are %ore $.u!e on %a0n0 an$ %ore fre9uentl& treate$,th %a!tecto%&+

 The current !tu$& foun$ that HER2neu-po!t"e tu%or! ,erea!!ocate$ ,th lar0er appearance on %a0n0 than HER2neu-

ne0at"e< %an& 0roup! report that lar0er tu%or! !houl$ *e treate$,th %a!tecto%&+' Th! !tu$& a! ,ell a! Ra5o"tch et al+' reportthat patent! ,ho are HER2neu-po!t"e are three t%e! %ore l5el&to un$er0o %a!tecto%& than HER2neu-ne0at"e patent!+

 3ur0cal opton! nclu$e %a!tecto%&/ lu%pecto%&/ an$lu%pecto%& plu! ra$aton+ 3ur0eon! ha"e u!e$ the u!e$ "arou!%o$el! to tr& to pre$ct preoperat"el& ,hch patent! ,ll *e 0oo$can$$ate! for lu%pecto%& "er!u! %a!tecto%&+

Discussion

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the an Nu&! Pro0no!tc In$e# (NPI)/ ! a !%ple!corn0 %etho$ that ha! *een u!e$ n the Unte$ 3tate!for %ore than ' &ear! to !tratf& patent! ,th $.erentr!5! of local recurrence to $e-c$e ,hch patent! are0oo$ can$$ate! for *rea!t con!er"aton F ra$aton+

Discussion

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 Th! !tu$& ! retro!pect"e/ ,hch ntro$uce!

!electon *a!+   La!tl&/ the !tu$& ! una*le to pro"$e $e:nt"e

e#planaton of ,h& Her2neu-po!t"e tu%or! are!0n:cantl& %ore e#ten!"e/ ,hether t ! actualle!on !8e or $etecta*lt& on %a%%o0ra%+

Discussion

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In conclu!on/ patent! ,th HER2-po!t"e D4I3

ha$ 0reater e#tent of $!ea!e *& %a0n0 an$,ere %ore l5el& to un$er0o %a!tecto%& thanHER2neu-ne0at"e+

A !tu$& ,th a lar0er !a%ple !8e %a& re"ealthat HER2neu-po!t"e D4I3 ! %ore $.u!e an$%ultfocal/ a 9ue!ton that $e!er"e! further

n"e!t0aton+

Discussion

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