ABSTRACT
OBJECTIVES: Patients with HER2-positive invasive breast cancer that is node-positive and/or larger than 3 cm are generally treated with neoadjuvant chemotherapy (NAC). We aimed to identify predictive markers for pathological complete response (pCR) after NAC in HER2-positive breast carcinoma. METHODS: Hematoxylin/eosin-stained slides of 43 HER2-positive breast carcinoma biopsies were histopathologically reviewed. Immunohistochemistry (IHC) was performed on pre-NAC biopsies, comprising HER2, estrogen receptor (ER), progesterone receptor (PR), Ki-67, epidermal growth factor receptor (EGFR), mucin-4 (MUC4), p53 and p63. Dual-probe HER2 in situ hybridization (ISH) was performed to study the mean HER2 and CEP17 copy numbers. ISH and IHC data were retrospectively collected for a validation cohort, comprising 33 patients. RESULTS: Younger age at diagnosis, 3+ HER2 IHC scores, high mean HER2 copy numbers and high mean HER2/CEP17 ratios were significantly associated with an increased chance of achieving a pCR, and the latter two associations were confirmed in the validation cohort. No other immunohistochemical or histopathological markers were associated with pCR. CONCLUSIONS: This retrospective study of two community-based NAC-treated HER2-positive breast cancer patient cohorts identified high mean HER2 copy numbers as a strong predictor for pCR. Further studies on larger cohorts are required to determine a precise cut-point for this predictive marker.
Subject(s)
Breast Neoplasms , Neoadjuvant Therapy , Humans , Female , Retrospective Studies , Biomarkers, Tumor/metabolism , Receptor, ErbB-2/analysis , Breast Neoplasms/drug therapy , Breast Neoplasms/genetics , Breast Neoplasms/metabolism , Receptors, Progesterone/metabolismABSTRACT
A 77-year-old woman presented with an intrapelvic cyst which had developed secondary to polyethylene wear of the socket after total hip arthroplasty. This reactive cyst surrounded polymethylmethacrylate cement fragments due to excessive penetration in the pelvis during the initial procedure 20 years previously. This pelvic mass was responsible for gynaecologic symptoms. The cyst was resected in a first stage. Revision hip arthroplasty is scheduled because of cup wear and progressive femoral osteolysis. Cement extrusion must be avoided during total hip arthroplasty to prevent pelvic complications, since these problems can present even several years later. Cement intrusion into the pelvis possibly opens up a pathway for polyethylene wear particles to migrate into the pelvis.
