HER2/neu gene determination in women screened for breast carcinoma: How screening programs reduce the skyrocketing cost of targeted therapy

Matteo Brunelli, Erminia Manfrin, Emilio Bria, Francesco Massari, Giampaolo Tortora, Eleonora Brunello, Luisa Carbognin, Alessia Nottegar, Jenny Furlanetto, Annamaria Molino, Elena Fiorio, Marco Chilosi, Bharat Jasani, Marco Vergine, Lisa Marcolini, Dea Filippini, Aldo Scarpa, Guido Martignoni, Franco Bonetti

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Abstract

Few data on Human Epidermal Growth Factor Receptor 2 (HER2)-positive breast carcinomas have been reported for screen-detected breast carcinoma. Assessing the impact of a targeted intervention with anti-HER2 inhibitors on costs is required in order to plan for better strategies in screening programs. A total of 54,472 women were screened and 323 cases were found to be invasive cancer. We performed immunophenotypical-fluorescent in situ hybridization (FISH) analysis. Among 153 evaluable breast carcinomas, tumours displayed a 3+ scoring status 3+ in 16 (10%), 2+ in 12 (8%), 1+ in 29 (19%) and 0 in 96 (63%) of cases, respectively. All 3+ HER2+ cases and 2/12 2+ (17%) cases exhibited HER2/neu gene amplification, the remaining cases did not. In contrast to the higher incidence reported at the population level, 20-30% HER2-positive cases for metastatic carcinomas, and only 11% of the screen-detected breast carcinomas displayed HER2/neu gene amplification. Breast cancer detection by screening programs hijacks the skyrocketing cost of the use of targeted therapy in HER2-positive carcinoma.

Original languageEnglish
Pages (from-to)3705-3710
Number of pages6
JournalAnticancer Research
Volume33
Issue number9
Publication statusPublished - Sep 1 2013

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Keywords

  • Cost-effectiveness
  • Gene amplification
  • HER2
  • Screen-detected breast carcinoma
  • Screening
  • Targeted therapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Brunelli, M., Manfrin, E., Bria, E., Massari, F., Tortora, G., Brunello, E., Carbognin, L., Nottegar, A., Furlanetto, J., Molino, A., Fiorio, E., Chilosi, M., Jasani, B., Vergine, M., Marcolini, L., Filippini, D., Scarpa, A., Martignoni, G., & Bonetti, F. (2013). HER2/neu gene determination in women screened for breast carcinoma: How screening programs reduce the skyrocketing cost of targeted therapy. Anticancer Research, 33(9), 3705-3710.