The relationship between Helix pomatia lectin (HPA) staining, c-erbB-2 expression, and other prognostic factors in breast cancer, i.e., axillary (AX) and internal mammary lymph node (IMN) metastases was assessed. The prognostic value of HPA staining and c-erbB-2 expression in combination was analyzed. HPA status was found to be significantly correlated with tumor size, and with AX and IMN metastases, whereas c-erbB-2 was significantly correlated only with AX and IMN metastases. A univariate study revealed that disease-free and overall survival were correlated significantly with tumor size, with AX and IMN metastases, and with HPA and c-erbB-2 status. Moreover, c-erbB-2 status was predictive of a poorer prognosis in both HPA+ and HPA- groups, and HPA+/c-erB-2+ patients had the worst prognosis when compared to the other subgroups. In a multivariate study, however, only AX and IMN metastases were significant prognostic factors. A combination of HPA staining and c-erbB-2 expression failed to provide any additional prognostic information. In patients in whom regional lymph node dissection has not been performed, however, one should take into account not only HPA binding status, but also c-erbB-2 oncoprotein status to discriminate more precisely those sub-populations with a high recurrence risk and predicted short survival who would be candidates for more aggressive therapy.

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