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How relevant is hormone receptor status in the context of outcome to HER2-positive breast cancer?

DOI: 10.1186/bcr3335

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Abstract:

In this era of personalized medicine and emphasis on identifying prognostic and predictive molecular profiles, breast tumor testing for hormone receptor status and HER2 remain the most relevant markers for practice. In the manuscript accompanying this editorial, Vaz-Luis and colleagues [1] address the combined role of these markers on the natural history of disease and outcome after therapy.Distinct differences in short- and long-term recurrence rates after a diagnosis of invasive estrogen receptor (ER)-positive breast cancer have been previously documented [2,3]. Specifically, these tumors tend to recur at a pretty constant rate over many years. Clinical outcome of patients with invasive HER2-positive breast cancer has been evaluated since 1998, when HER2 testing first received formal approval as predictive of benefit to the anti-HER2 therapy, trastuzumab. These tumors tend to have a peak of recurrence at 2-3 years from diagnosis, then a lower rate of recurrence, which have been uncovered with appropriate HER2 testing and interpretation [4-8]. The question at hand is how they interact with each other to predict clinical outcome. Cross-talk between ER and HER2 pathways may result in synergistic tumor progression, differential sensitivity to therapies, and differential sites of tumor relapse [9].Well, what did the investigators find and how can we place it into the context of biology and other existing data? Vaz-Luis and colleagues are to be congratulated for gathering outcome data from 3,394 patients, diagnosed with HER2-positive breast cancer based on local laboratory testing between 2000 and 2007, and grouping them based on hormone receptor status. The exact type of HER2 testing or definition of positivity were not described, though presumed to be based on the US Food and Drug Administration (FDA)-approved guidelines [4], as the American Society of Clinical Oncology/College of American Pathologists guidelines first became available in 2007 [8]. Hormone receptor st

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