The Impact of Stage and Molecular Subtypes on Survival Outcomes in Young Women with Breast Cancer.

Young women form a unique cohort in breast cancer, with evidence suggesting a later stage at presentation with more aggressive cancers. We aimed at evaluating the prognostic significance of young age and the impact of stage and molecular subtypes on survival. We conducted an audit of a prospectively maintained database at our institute between 2010 and 2014. All women with available receptor status and documented follow-up were included. The young breast cancer (YBC) cohort comprised 103 women and 230 women constituted the comparator arm (45-55 years). The median follow-up was 4 years. The YBC had a higher incidence of hormone negative tumors (61.1% vs. 46.3%, p = 0.012, significant [S]); however, both groups were similar in their stage at presentation. On classification into luminal subtypes, triple negative breast cancer was more common in the YBC cohort (50.5% vs. 29.6%, p = 0.001, S). The 5-year disease-free survival (DFS) was significantly worse in the YBC cohort (70.3% vs. 78%, p = 0.03, S). This detriment appeared to be significantly more in women presenting with operable breast cancer (77.2% vs. 82.6%, p = 0.012, S). Among the Luminal subtypes, there was no significant difference in the DFS between the two groups. Young age is a negative prognostic factor among women presenting with breast cancer. Further studies are required to evaluate whether any specific stage or molecular sub-type is particularly vulnerable to a poor outcome despite treatment.

HER2 expression in gastric cancer in Indian population--an immunohistochemistry and fluorescence in situ hybridization study.

AIM: Human epidermal growth factor receptor (HER2, also known neu, ERBB2) protein expression in gastric cancer is associated with poor prognosis, aggressive disease and poor response to chemotherapy. Trastuzumab, a monoclonal antibody against HER2, in combination with chemotherapy is currently advocated as a new standard option for patients with HER2-positive advanced gastric and gastroesophageal junction carcinoma. Frequency of HER2 expression in gastric cancer has been reported from different geographic zones with a wide range of 13 % to 91 %. There are no reported data of HER2 protein expression in gastric cancer tissue from India. The purpose of this study was to evaluate the frequency of HER2 expression in gastric cancer. METHODS: The frequency of HER2 expression in 52 patients with gastric adenocarcinoma was prospectively evaluated over a six month period at Asian Institute of Gastroenterology from January 2010 to July 2010, using immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). RESULTS: HER2 overexpression was confirmed in 23 of 52 (44.2 %) patients. Two patients had equivocal result by IHC (2+), one of whom was positive on analysis by FISH. There was no difference in HER2 overexpression (positivity) or negativity in relation to age, gender, tumor site, histological subtype, tumor differentiation, serosal involvement or lymph nodal status. HER2 overexpression rates were similar for intestinal type as compared to diffuse histological type (OR 1.84), as also for proximal as compared to distal gastric cancers (OR 0.81). CONCLUSION: HER2 overexpression was observed in significant number of advanced gastric adenocarcinoma patients. There was no difference in HER2 overexpression in relation to clinicopathological parameters.