High prevalence of HER-2/neu overexpression in female breast cancer among an Iraqi population exposed to depleted uranium

Esraa A AL-Dujaily1, Asad A Al-Janabi1, Tomasz Pierscionek2, Akeel A Yasseen3
1Department of Pathology and Forensic Medicine, Faculty of Medicine, Kufa, University, Kufa, P.O. Box 18, Iraq,
2The Medical School, Newcastle University, Framlington Place, Newcastle-upon-Tyne, NE2 4HH, United Kingdom,
3Department of Pathology and Forensic Medicine, Faculty of Medicine, Kufa, University, Kufa, P.O. Box 18, Iraq; School of Biomedical Sciences, University of Ulster, Cromore Road, Coleraine, BT52 1SA, United Kingdom,
DOI: 10.4103/1477-3163.44026

ABSTRACT

Background: This study aimed to estimate the rate of HER-2/neu (c-erbB2) immunohistochemical overexpression in different histological types of breast cancer found in the middle Euphrates region of Iraq, a region that was exposed to high levels of depleted uranium. HER-2/neu (c-erbB2) overexpression was correlated with common clinicopathological parameters such as age, grade, stage, tumor size and lymph node involvement to determine if any particular biomarker for exposure to depleted uranium could be found in the tumor samples from this region. Materials and Methods: The present investigation was performed over a period starting from September 2007 to June 2008. Formalin-fixed, paraffin-embedded blocks from 90 patients with breast cancer were included in this study. A group of 25 patients with benign breast lesions (fibroadenoma) was included as a comparative group, and 20 breast tissue sections were used as controls. Labeled streptavidin-biotin (LSAB) complex method was employed for immunohistochemical detection of HER-2/neu. Results: HER-2/neu immuno-expression was positive in 67.8% of breast cancer, while it was negative in all benign breast lesions (fibroadenoma) ( P < 0.05). HER-2/neu immunostaining was significantly associated with histological type and recurrence of breast cancer ( P < 0.05). It was positively correlated with tumor grade, but this finding was not significant ( P > 0.05). Conclusion: Based upon the findings of this study, it can be concluded that HER-2/neu overexpression plays an important role in the pathogenesis of breast cancer and is associated with a worse prognosis. The findings indicate that in regions exposed to high levels of depleted uranium, HER-2/neu overexpression is high, but its correlation with age, grade, stage, tumor size, and lymph node involvement is similar to studies that have been conducted on populations not exposed to depleted uranium.

Keywords: Breast cancer, gene overexpression, HER-2/neu receptor, immunohistochemistry.