background • human epidermal growth factor receptor 2 (hER2) is a significant predictive factor for benefit from adjuvant trastuzumab (hER2-targeted therapy) which is considered the standard treatment for patients with hER2+ early breast cancer (EBC) after completion of adjuvant chemotherapy. we aimed to determine whether the high level of hER2 positivity would influence the outcome of adjuvant trastuzumab and the prognosis at diagnosis. Patients and Methods • A total of 157 patients with EBC (hER2 positive, lymph nodepositive, hormonal receptors negative) who received adjuvant chemotherapy and trastuzumab (8 mg/kg intravenously as a loading dose followed by 6 mg/kg every 3 weeks for 6 months) at Albairouni University hospital. this is a single institute study with two arms based on hER2 positivity ratio. Group A (hER2 FISh ratio ≤ 4; n = 91 patients), and group B (hER2 FISh ratio > 4; n = 66 patients). the primary endpoint was 3-year disease free survival (DFS) in relation to hER2 FISh ratio. Results • the 3-year DFS in the group A was 75.8%, while it was 77.2% in the group B (p = 0.31). Stages II and III in the group A were 32% and 68% respectively, while in the group B they were 27.27% and 72.72% respectively. Grades (I-II) and (III-Iv) in group A were 60.4% and 39.6% respectively, while in group B they were 68.18% and 31.81% respectively. Differences were not statistically significant. Conclusion • the high degree of hER2 amplification (FISh ratio > 4 vs. ≤ 4) has no significant influence on either outcome from adjuvant trastuzumab or prognosis in hER2 + EBC.

Keywords: early breast cancer; HER2; Trastuzumab

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