Young
breast cancer patients have a decreased survival rate and it has been demonstrated that young age is an independent predictor of adverse prognosis. Overexpression of
c-erbB-2 protein (also known as HER-2/neu) has been shown to be a prognostic
indicator in
breast cancer in general and especially among patients with axillary nodal
metastases. The present study was initiated to determine the prognostic significance of
c-erbB-2 protein overexpression in early onset
breast cancer. A population consisting of 110 young
breast cancer patients, < or = 36-year-old at diagnosis, was analyzed with immunohistochemical staining for
c-erbB-2 protein. Thirty patients (27%) were found to overexpress the
c-erbB-2 protein. C-erbB-2 positivity was significantly associated with poor survival when all patients were included in the analysis (P = 0.002) and for patients with axillary nodal
metastases (P = 0.0007). No such association was found for node-negative patients. Furthermore, the difference in prognosis in relation to c-erbB-2 among node-positive patients was maintained, when these were stratified in groups treated or not treated with
adjuvant chemotherapy. The study indicates that overexpression of
c-erbB-2 protein is a strong prognostic factor in young
breast cancer patients with axillary nodal
metastases. Moreover, the adverse prognosis associated with c-erbB-2 overexpression in node-positive patients was observed whether or not the patients had received
adjuvant chemotherapy.