Axillary lymph node status of operable breast cancers by combined steroid receptor and HER-2 status: Triple positive tumours are more likely lymph node positive

Ben Van Calster, Isabelle Vanden Bempt, Maria Drijkoningen, Nathalie Pochet, Jiqiu Cheng, Sabine Van Huffel, Wouter R. Hendrickx, Julie Decock, Huei Jean Huang, Karin Leunen, Frederic Amant, Patrick Berteloot, Robert Paridaens, Hans Wildiers, Erik Van Limbergen, Caroline Weltens, Dirk Timmerman, Toon Van Gorp, Ann Smeets, Walter Van Den BogaertIgnace Vergote, Marie Rose Christiaens, Patrick Neven

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64 Citations (Scopus)


Aims: To examine the frequency of axillary lymph node (ALN) invasion of operable breast cancers by their combined oestrogen receptor (ER), progesterone receptor (PR) and HER-2 status. Methods: 2227 recently operated cases in one centre were retrieved from the Multidisciplinary Breast Centre database and stratified according to their combined immunohistochemical (IHC) expression of ER/PR/HER-2 status. An equivocal HER-2 status was further analysed by Fluorescence in situ Hybridisation (FISH). The following 6 groups were considered: ER-PR-HER-2- (NNN; triple negative), ER-PR-HER-2+ (NNP), ER +PR-HER-2- (PNN), ER+PR -HER-2+ (PNP), ER+PR+HER-2 - (PPN), ER+PR+HER-2+ (PPP; triple positive). For ALN, the following variables were tested in uni- and multivariate models: age at diagnosis (years), tumour size (mm), tumour grade, ER, PR, HER-2 and the combined steroid receptor and HER-2 status. Likelihood ratio χ2-tests were used for univariate analysis and logistic regression for multivariate analysis. Results: Triple positive tumours had a higher likelihood of being ALN positive than others (56.2% versus 35.7%; P < 0.0001). Univariate logistic regression also withheld age, size, grade and HER-2 as predictors of ALN involvement. Final multivariate logistic regression revealed age, size, grade and PPP versus non-PPP to be independent predictors of ALN involvement; the odds ratio (OR) and 95% CI for PPP versus non-PPP tumours was 2.169 (1.490-3.156). Conclusion: Our data provide insight into the natural history of triple positive breast carcinomas. Such tumours are more likely ALN positive than those with another steroid receptor and HER-2 status. How these findings correlate with breast cancer prognosis remains to be investigated.

Original languageEnglish
Pages (from-to)181-187
Number of pages7
JournalBreast Cancer Research and Treatment
Issue number1
Publication statusPublished - 1 Jan 2009
Externally publishedYes



  • Breast cancer
  • HER-2
  • Lymph node
  • Steroid receptors

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Van Calster, B., Vanden Bempt, I., Drijkoningen, M., Pochet, N., Cheng, J., Van Huffel, S., Hendrickx, W. R., Decock, J., Huang, H. J., Leunen, K., Amant, F., Berteloot, P., Paridaens, R., Wildiers, H., Van Limbergen, E., Weltens, C., Timmerman, D., Van Gorp, T., Smeets, A., ... Neven, P. (2009). Axillary lymph node status of operable breast cancers by combined steroid receptor and HER-2 status: Triple positive tumours are more likely lymph node positive. Breast Cancer Research and Treatment, 113(1), 181-187.