HER2/neu Levels, Premature Termination of Pregnancy and Breast Cancer Risk: A Hospital-Based Study from Lahore, Pakistan

Abstract

Breast cancer is a leading cause of death in women. The objective of the present study was to evaluate diagnostic utility of HER2/neu test and the association of premature termination of pregnancy with breast cancer. Two hundred breast cancer patients from INMOL hospital, Lahore (Pakistan) were interviewed on reproductive factors. HER2/neu levels were determined by ELISA from 52 patients and 37 age-matched control women. The results of survey study showed that "premature termination of pregnancy" emerges as a potential risk factor of breast cancer. Number of pregnancies has significant association with premature termination of pregnancies (P = 6 × 10-11). The regression coefficient for number of pregnancies is 0.220 ± 0.029= 1.25× i.e. a 25% increase for each additional pregnancy. There is a significant positive association between premature termination of pregnancies and number of children (P = 0.024): the regression coefficient is 0.108±0.048=1.11× i.e. 11% increase for each additional child. The analysis of Her2/neu showed that its levels were higher in younger patients (≤ 42 years) than in older patients (0.884 vs 0.614 units, P= 0.049). The ROC curve indicated that the optimal test (maximum Se + Sp) occurred at HER-2 Neu values of = 0.615, where Se= 0.73 and Sp= 0.49. The AUC value for this test was 0.57, with 1 being a perfect test, and 0.5 being equivalent to random allocation. In brief, premature termination of pregnancy/ miscarriage is a potential risk factor and HER2/neu cannot be used as a suitable diagnostic test.