Abstract
The epidermal growth factor receptor (EGFR) is a transmembrane glycoprotein whose expression is important in the regulation of breast cancer cell growth. The relationship between EGFR status (determined by an immunocytochemical assay) and various prognostic factors was investigated in 164 primary breast cancers. Overall 56% of tumours were EGFR-positive and the expression of EGFR was unrelated to axillary node status, tumour size and histological grade; and it was poorly associated with the tumour proliferative activity measured by Ki-67 immuno-cytochemistry. The relapse-free survival (RFS) probability at 3-years was significantly worse for patients with EGFR positive tumours (P = 0.003) and for those whose Ki-67 score was > 7.5% (P = 0.0027), as well as in patients with axillary node involvement (P = 0.01) and with poorly differentiated tumours (P = 0.04). Immunocytochemical determination of EGFR and cell kinetics gave superimposable prognostic information for predicting RFS with odds ratios of 3.51, when evaluated singly. In our series of patients EGFR, Ki-67 and node status retain their prognostic value concerning RFS in multivariate analysis. The 3-year probability of overall survival (OS) was significantly better in node-negative patients (P = 0.04) and was similar in EGFR-positive and negative patients. In conclusion, EGFR status appears to be a significant and independent indicator of recurrence in human breast cancer and the concomitant measurement of the tumour proliferative activity seems to improve the selection of patients with different risks of recurrence.
Highlights
Recent studies have reported that overexpression of the epidermal growth factor receptor (EGFR) was associated both with enhanced metastatic potential of some breast cancer cell lines (Fitzpatrick et al, 1984; Roos et al, 1986) and with high risk of early recurrence and death in some clinical studies (Sainsbury et al, 1987; Macias et al, 1987; Toi et al, 1991)
There is no unequivocal evidence that amplification of EGFR is the initial transforming event in human breast carcinoma (Stoscheck & King, 1986; Heldin & Westermark, 1984), an autocrine mechanism is considered as an important step for the independent growth of tumour cells (Lippman et al, 1986; Salomon et al, 1984)
Seventy-two tumours had only a weak focal or failed to retain any convincing membrane staining. This frequency of EGFR positivity is in accordance with that previously found by our group (Bevilacqua et al, 1990) and by others (Sainsbury et al, 1985)
Summary
Recent studies have reported that overexpression of the epidermal growth factor receptor (EGFR) was associated both with enhanced metastatic potential of some breast cancer cell lines (Fitzpatrick et al, 1984; Roos et al, 1986) and with high risk of early recurrence and death in some clinical studies (Sainsbury et al, 1987; Macias et al, 1987; Toi et al, 1991). There is no unequivocal evidence that amplification of EGFR is the initial transforming event in human breast carcinoma (Stoscheck & King, 1986; Heldin & Westermark, 1984), an autocrine mechanism is considered as an important step for the independent growth of tumour cells (Lippman et al, 1986; Salomon et al, 1984). The prognostic significance of EGFR status needs further investigation (Bonadonna, 1990)
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