الفهرس 
REVIEW OF LITERATUREOnly 14 pages are availabe for public view
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Abstract
This study was conducted at National Cancer Institute, Cairo Univ., Egypt. Breast cancer is a complex and heterogeneous disease. According to the NCI registry, Cairo University, the breast cancer ranks the first among all cancer cases.
The material of this work comprised 50 females patient with invasive duct breast carcinomas, from the pathology department of the NCI, Cairo University during the period 2008-2011, and their age ranged from 25 to 60 years with a mean of 44.74 years (median of 44years).
The main goal of this investigation was to assess of C-erbB-4 oncogene amplification byRT- PCR and EGFR by immunohistochimical analysis; and its relation to other histopathological features of prognostic significance. Prognostic factors such as tumor size, tumor grading, hormone receptor status, age, mitotic indix and oncogene alterations were analysed to define sub groups of high risk breast cancer patients.
RNA extraction from cancer breast tissue and adjacent normal tissue as control was done. RT-PCR was used only to assess C-erbB-4 and immunohistochemical staining method was used for EGFR, ER and PR.
Four out of 50 (8 %) cases were less than 30 years, 31 (62%) cases their age ranged from >30 - 50 years and 15 cases (30%) were older than 50 years. Twenty seven of 50 cases (54%) were premenopausal, According to the tumor grade, the 50 cases were subgrouped to 42 cases (84%) grade II while 8 cases (16%) were grade III. Tumor size ranged from 0.5 to 7 cm, twenty five cases (50%) were below 4 cm in diameter, twenty five cases (50%) larger than 4 cm. Thirty one out of 50 (62%) cases showed axillary lymph nodes involvement.
EGFR expression showed direct significant association with lymph node capsular invasion, while inverse significant association with C-erbB-4 amplification and Estrogen and Progesterone receptors. EGFR expression was statistically insignificant with tumor size, and Menopausal status.
C-erbB-4 amplification showed inverse significant association with lymph node status and EGFR expression, while direct significant association with Estrogen and Progesterone receptors was detected c-erbB-4 amplification
showed insignificant association with menopausal status, histological grade, tumor size and different age group.
Finally it could be concluded that EGFR could be considered as poor prognostic markers in cancer breast, while c-erB-4 could be considered as one of the favourable prognostic markers in cancer breast.
It has been found in this study that breast cancer patients expressing EGFR only had more unfavourable prognostic markers (positive lymph node involvement, negative estrogen receptor) compared with these expressing c-erbB-4. This could be explained by the fact that c-erbB-4 could antagonize the EGFR effect on the clinical course of the disease.
Further studies on a larger number of patients are needed to detect the role of EGFR, and C-erbB-4 expression in cancer breast progression and development. This could help in evaluation of the impact of such factors and in selection of breast cancer patients at high risk for poor prognosis and thus for more aggressive treatment.
Assessment of C-erbB-4 expression in breast cancer patients in addition with EGFR could be of value in modifying the judgement regarding poor prognosis and more aggressive treatment when considering EGFR only.
Rotine Immunostaining of EGFR for all cases of breast cancer, in addition to ER, PR and Her-2 neu. C-erb4 could be done on selected cases only are recomended.
This study was conducted at National Cancer Institute, Cairo Univ., Egypt. Breast cancer is a complex and heterogeneous disease. According to the NCI registry, Cairo University, the breast cancer ranks the first among all cancer cases.
The material of this work comprised 50 females patient with invasive duct breast carcinomas, from the pathology department of the NCI, Cairo University during the period 2008-2011, and their age ranged from 25 to 60 years with a mean of 44.74 years (median of 44years).
The main goal of this investigation was to assess of C-erbB-4 oncogene amplification byRT- PCR and EGFR by immunohistochimical analysis; and its relation to other histopathological features of prognostic significance. Prognostic factors such as tumor size, tumor grading, hormone receptor status, age, mitotic indix and oncogene alterations were analysed to define sub groups of high risk breast cancer patients.
RNA extraction from cancer breast tissue and adjacent normal tissue as control was done. RT-PCR was used only to assess C-erbB-4 and immunohistochemical staining method was used for EGFR, ER and PR.
Four out of 50 (8 %) cases were less than 30 years, 31 (62%) cases their age ranged from >30 - 50 years and 15 cases (30%) were older than 50 years. Twenty seven of 50 cases (54%) were premenopausal, According to the tumor grade, the 50 cases were subgrouped to 42 cases (84%) grade II while 8 cases (16%) were grade III. Tumor size ranged from 0.5 to 7 cm, twenty five cases (50%) were below 4 cm in diameter, twenty five cases (50%) larger than 4 cm. Thirty one out of 50 (62%) cases showed axillary lymph nodes involvement.
EGFR expression showed direct significant association with lymph node capsular invasion, while inverse significant association with C-erbB-4 amplification and Estrogen and Progesterone receptors. EGFR expression was statistically insignificant with tumor size, and Menopausal status.
C-erbB-4 amplification showed inverse significant association with lymph node status and EGFR expression, while direct significant association with Estrogen and Progesterone receptors was detected c-erbB-4 amplification
showed insignificant association with menopausal status, histological grade, tumor size and different age group.
Finally it could be concluded that EGFR could be considered as poor prognostic markers in cancer breast, while c-erB-4 could be considered as one of the favourable prognostic markers in cancer breast.
It has been found in this study that breast cancer patients expressing EGFR only had more unfavourable prognostic markers (positive lymph node involvement, negative estrogen receptor) compared with these expressing c-erbB-4. This could be explained by the fact that c-erbB-4 could antagonize the EGFR effect on the clinical course of the disease.
Further studies on a larger number of patients are needed to detect the role of EGFR, and C-erbB-4 expression in cancer breast progression and development. This could help in evaluation of the impact of such factors and in selection of breast cancer patients at high risk for poor prognosis and thus for more aggressive treatment.
Assessment of C-erbB-4 expression in breast cancer patients in addition with EGFR could be of value in modifying the judgement regarding poor prognosis and more aggressive treatment when considering EGFR only.
Rotine Immunostaining of EGFR for all cases of breast cancer, in addition to ER, PR and Her-2 neu. C-erb4 could be done on selected cases only are recomended.