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Japanese Journal of Clinical Oncology Advance Access published online on October 4, 2008
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyn103
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© The Author (2008). Published by Oxford University Press. All rights reserved

HER-2 Protein Overexpression in Metastatic Breast Carcinoma Found at Autopsy

Shigeya Kyoda1, Satoki Kinoshita2, Hiroshi Takeyama1, Ken Uchida2 and Toshiaki Morikawa2

1 Department of Surgery, Jikei University Daisan Hospital, Komae and
2 Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan

For reprints and all correspondence: Shigeya Kyoda, Department of Surgery, Jikei University Daisan Hospital, 4-11-1 Izumi-honchou, Komae, Tokyo 201-8601, Japan. E-mail: vez06074{at}nifty.ne.jp

Received November 5, 2007; accepted September 3, 2008

Objective: The overexpression of HER-2 protein has generally been considered to be consistent in primary and metastatic tumor tissues. We evaluated HER-2 protein overexpression levels in 31 autopsied cases.

Methods: Hematoxylin–eosin staining and immunohistological staining Hercep Test IITM were performed on the primary tumors and the lung, liver, brain and bone metastatic tumors.

Results: Nine (29%) of the 31 primary tumors were HER-2 score 3+ and HER-2 score 3+ cases were significantly more frequent in carcinomas of nuclear Grade 3 than in those of Grade 1 or 2. In these 31 patients, the HER-2 status in the primary tumors was consistent with the metastatic foci of the lung, liver, brain and bone in 96% (25 of 26), 91% (21 of 23), 100% (12 of 12) and 85% (11 of 13), respectively. With regard to the nine patients with HER-2 score 3+ primary tumors, the HER-2 status in the primary tumors was consistent with the metastatic foci of the lung, liver, brain and bone in 87% (seven of eight), 78% (seven of nine), 100% (only one) and 33% (one of three), respectively. In 11 (92%) of the 12 patients with brain metastasis, the HER-2 was not overexpressed.

Conclusions: Even in the far-advanced stages of autopsy, HER-2 status of the primary tumors appeared to be maintained especially in the foci of the lung, liver and brain metastases. As there was a high degree of agreement in HER-2 status between the primary tumors and the metastatic foci to the lung, liver and brain, it is considered to be reasonable to treat patients with such metastatic foci based on the HER-2 status of the primary tumors.

Key Words: breast cancer • nuclear grade • HER-2 protein overexpression • autopsied patients


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