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Breast Cancer Res. 2009; 11(1): R9.
Published online 2009 February 19. doi:  10.1186/bcr2225
PMCID: PMC2687713
Copyright © 2009 Zell et al.; licensee BioMed Central Ltd.
Prognostic impact of human epidermal growth factor-like receptor 2 and hormone receptor status in inflammatory breast cancer (IBC): analysis of 2,014 IBC patient cases from the California Cancer Registry
Jason A Zell,corresponding author1,2,3 Walter Y Tsang,4 Thomas H Taylor,1 Rita S Mehta,2,3 and Hoda Anton-Culver1
1Department of Epidemiology, Genetic Epidemiology Research Institute, School of Medicine, University of California Irvine, 224 Irvine Hall, Irvine, CA 92697, USA
2Chao Family Comprehensive Cancer Center, University of California Irvine Medical Center, 101 The City Drive South, Orange, CA 92868, USA
3Division of Hematology/Oncology, Department of Medicine, School of Medicine, University of California Irvine Medical Center, 101 The City Drive South, Orange, CA 92868, USA
4Department of Medicine, School of Medicine, University of California Irvine Medical Center, 101 The City Drive South, Orange, CA 92868, USA
corresponding authorCorresponding author.
Jason A Zell: jzell/at/uci.edu; Walter Y Tsang: wtsang/at/uci.edu; Thomas H Taylor: thtaylor/at/uci.edu; Rita S Mehta: rsmehta/at/uci.edu; Hoda Anton-Culver: hantoncu/at/uci.edu
Received October 9, 2008; Revisions requested January 30, 2009; Revised February 10, 2009; Accepted February 19, 2009.
This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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Abstract
Introduction
Inflammatory breast cancer (IBC) is an aggressive form of breast cancer associated with overexpression of Her2/Neu (human epidermal growth factor-like receptor 2 (HER2)) and poor survival. We investigated survival differences for IBC patient cases based on hormone receptor status and HER2 receptor status using data from the California Cancer Registry, as contrasted with locally advanced breast cancer (LABC), metastatic breast cancer (MBC) and non-T4 breast cancer.
Methods
A case-only analysis of 80,099 incident female breast cancer patient cases in the California Cancer Registry during 1999 to 2003 was performed, with follow-up through March 2007. Overall survival (OS) and breast cancer-specific survival (BC-SS) were analyzed using Kaplan–Meier methods and Cox proportional hazards ratios.
Results
A total of 2,014 IBC, 1,268 LABC, 3,059 MBC, and 73,758 non-T4 breast cancer patient cases were identified. HER2+ was associated with advanced tumor stage (P < 0.0001). IBC patient cases were more likely to be HER2+ (40%) and less likely to be hormone receptor-positive (HmR+) (59%) compared with LABC (35% and 69%, respectively), MBC (35% and 74%), and non-T4 patient cases (22% and 82%). HmR+ status was associated with improved OS and BC-SS for each breast cancer subtype after adjustment for clinically relevant factors. In multivariate analysis, HER2+ (versus HER2-) status was associated with poor BC-SS for non-T4 patient cases (hazards ratio = 1.16, 95% confidence interval 1.05 to 1.28) and had a borderline significant association with improved BC-SS for IBC (hazards ratio = 0.82, 95% confidence interval = 0.68 to 0.99).
Conclusions
Despite an association with advanced tumor stage, HER2+ status is not an independent adverse prognostic factor for survival among IBC patient cases.
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