Prognostic factors in HER2-positive breast cancer
leading cancer worldwide. [4] Despite advances in screening protocols and treatment options, certain subtypes
of breast cancer, such as HER2-positive (and hormone-negative) breast cancer, continue to have poor
prognosis. [5]
The interplay between environmental factors and breast cancer has been increasingly a topic of interest
among oncologists and scientists. Many studies have documented significant associations between nongenetic factors and the development and/or prognosis of breast cancer. For instance, exposure to exogenous
estrogen has been linked to luminal breast cancer relative to the incidence of other subtypes. [6] Similarly,
obesity has been linked to the development of breast cancer in postmenopausal women, and smoking has
been shown to increase risk of any breast cancer [7-8].
For my medical school graduation project, I hope to explore the aforementioned factors in relation to HER2-positive breast cancer and to stratify the patients based on age (pre- or post-menopausal) as well as baseline demographic
characteristics. This could help validate existing knowledge in a larger patient sample than previously done,
and help identify patients who require additional, non-routine screening relative to the general healthy
population.
My study population will derive from the PLCO database, which is publicly available. My inclusion criteria will
be all female patients in any age group, with a diagnosis of HER2-positive, ER-negative, Progesterone
Receptor-negative breast cancer. The number of patients with breast cancer in the PLCO database is 4561,
but the number of patients by histological subtype is not reported on the trial summary page.
- I will then use SPSS to conduct a multivariate Cox regression analysis to assess how each of the factors of BMI, smoking, and exposure to exogenous hormone therapy affect the morbidity and mortality outcomes in these patients.
- The specific measures and patient characteristics to be included in my analysis may change later. I would like
to review the most updated literature again before beginning my project to select the specific variables for
analysis.
Dr. Stella Major, Associate Professor of Family Medicine in Clinical Medicine, Weill Cornell Medicine-Qatar.