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Small HER2-Positive Breast Cancer: Should Size Affect Adjuvant Treatment?
Annette Tognela1, Jane Beith2, Belinda Kiely3
1Department of Medical Oncology, Campbelltown Hospital, Campbelltown, Australia; Macarthur Clinical School, University of Western Sydney, Campbelltown, Australia.
Introduction:
The adjuvant trastuzumab trials largely excluded women with small, node-negative, HER2-positive breast cancers. Accordingly, limited data exist regarding the effect of trastuzumab in the management of these patients. Our aim was to assess the outcomes of, and treatments administered to, women with small (≤ 2 cm), node-negative, HER2-positive breast cancer in 4 Australian cancer centers.
Patients And Methods:
A retrospective analysis of data on all women with node-negative, HER2-positive breast cancers ≤ 2 cm diagnosed between 1 January 2001 and 31 December 2011 and treated at 4 cancer centers in Sydney, Australia was undertaken. The primary outcomes were recurrence-free survival (RFS) and overall survival (OS).
Results:
In total, 128 patients with node-negative, HER2-positive breast cancers ≤ 2 cm were identified. Of these, 83 women (65%) received adjuvant trastuzumab which, in 96% of cases, was in addition to adjuvant chemotherapy. At 3-year follow-up, the RFS was 100% and 79.2% and the OS was 100% and 92.6% for women treated with, and without, trastuzumab, respectively. There were 14 recurrence events and 6 deaths in the study population. There were no significant differences in RFS and OS for the 46 women treated with, or without, trastuzumab for those with tumors ≤ 1 cm.
Conclusion:
There is a growing body of evidence to support the use of adjuvant trastuzumab therapy in the management of small, node-negative, HER2-positive breast cancers. However, future studies with longer follow-up and prospective biomarker analysis might assist in clinical decision-making for this patient group.
Insights
Adjuvant trastuzumab therapy improved outcomes for women with small, node-negative, HER2-positive breast cancer. Further research is needed to refine treatment decisions for this patient group.
Area of Science:
- Oncology
- Clinical Medicine
- Breast Cancer Research
Background:
- Adjuvant trastuzumab trials often excluded women with small, node-negative, HER2-positive breast cancers.
- Limited data exist on trastuzumab's efficacy in this specific patient population.
- This study addresses the outcomes and treatments for these underrepresented patients.
Purpose of the Study:
- To assess the outcomes of adjuvant trastuzumab therapy.
- To evaluate treatment patterns in women with small (≤ 2 cm), node-negative, HER2-positive breast cancer.
- To provide data for clinical decision-making in this subgroup.
Main Methods:
- Retrospective analysis of 128 patients with node-negative, HER2-positive breast cancer (≤ 2 cm).
- Data collected from 4 Australian cancer centers between 2001 and 2011.
- Primary outcomes: recurrence-free survival (RFS) and overall survival (OS).
Main Results:
- 83 women (65%) received adjuvant trastuzumab, typically with chemotherapy.
- At 3-year follow-up, RFS was 100% vs. 79.2% and OS was 100% vs. 92.6% for patients treated with vs. without trastuzumab.
- No significant differences in RFS or OS were observed for tumors ≤ 1 cm.
Conclusions:
- Evidence supports adjuvant trastuzumab for small, node-negative, HER2-positive breast cancers.
- Further long-term studies and biomarker analysis are recommended.
- This research aids in refining treatment strategies for this patient group.
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