Clinicopathological characteristics of patients with HER2-positive breast cancer and the efficacy of trastuzumab in the people’s republic of China

Abstract

Objective: The aim of this study was to describe the clinical features and outcomes of Chinese patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Method: The clinical data and survival statuses of 732 patients with operable HER2-positive breast cancer who were treated at the Department of Breast Surgery of the Shanghai Cancer Center from January 1, 2007, to December 31, 2011, were collected. The patients were divided into two groups according to treatment with and without trastuzumab. Disease-free survival (DFS) and overall survival were calculated using the Kaplan-Meier method and log-rank test. The associations of the patient characteristics with prognosis were analyzed via Cox regression. Results: A total of 732 women with HER2-positive breast cancer were included in this study, among whom 258 (35.2%) received trastuzumab. The median follow-up duration was 41 months. By the end of the follow-up period, 86 (12%) women experienced local recurrence or metastasis. Patients who received both anti-HER2 therapy and chemotherapy exhibited a longer DFS than those who received chemotherapy alone (P=0.001). Tumor size, lymph node status, and family history of breast cancer were associated with median DFS, and tumor size, lymph node status, clinical stage, age, and body mass index were associated with median over- all survival. Patients who received both neoadjuvant chemotherapy and trastuzumab exhibited a higher rate of pathological complete remission. In the neoadjuvant group, the patients who received both anti-HER2 therapy and chemotherapy exhibited a longer DFS than those who received chemotherapy alone (P=0.049). Conclusion: Significant clinical features were observed in the Chinese patients with HER2- positive breast cancer. Furthermore, targeted anti-HER2 therapy may improve the prognosis of these patients.