Background Triple-negative breast cancer (TNBC) represents an aggressive subset of breast malignancies defined by the absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). The lack of well-defined molecular targets significantly complicates prognosis and treatment planning. Among candidate biomarkers, the epidermal growth factor receptor (EGFR/ERBB1) has emerged as a promising contributor to TNBC pathobiology, with growing evidence supporting its diagnostic and therapeutic relevance. Objective This study aimed to assess the expression of EGFR in TNBC and to explore its relationship with key clinicopathological features and patient survival, thereby elucidating its potential role in disease progression and prognostic stratification. Methods A retrospective analysis was conducted on a cohort of 80 patients diagnosed with TNBC. EGFR protein expression was evaluated through immunohistochemical staining, and a semi-quantitative H-score was calculated for each case. Statistical analyses were performed to examine associations between EGFR expression and clinicopathological variables. Kaplan–Meier survival curves and Cox regression models were used to determine the prognostic significance of EGFR. Results EGFR expression was evaluated in 80 TNBC cases and stratified by H-score into four levels, revealing that 78% of tumors exhibited high to very high expression. Increased EGFR levels were significantly associated with larger tumor size (p = 0.0205), positive nodal status (p = 0.0233), and advanced TNM stage (p < 0.001). High EGFR expression correlated strongly with recurrence, particularly metastatic (p < 0.001), and with mortality (p < 0.001). Survival analysis showed reduced overall and disease-free survival in patients with elevated EGFR, supported by high AUC values in ROC analysis. Multivariate Cox regression confirmed EGFR as an independent prognostic factor for both OS (p = 0.013) and DFS (p = 0.006). Conclusion EGFR is closely linked to aggressive tumor behavior in TNBC and holds significant prognostic value. Its overexpression is indicative of worse survival outcomes and may inform treatment decisions. These findings support the incorporation of EGFR assessment into routine diagnostic workflows and highlight the need for further investigation into EGFR-targeted therapeutic strategies in TNBC.

Immunohistochemical Profiling of EGFR in Triple-Negative Breast Cancer: Diagnostic Utility and Prognostic Impact

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发表日期：

2025年10月13日

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Noura A. A. Ebrahim,
Nancy H. Amin,
Mustafa A. Hussein

摘要

Background

Triple-negative breast cancer (TNBC) represents an aggressive subset of breast malignancies defined by the absence of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). The lack of well-defined molecular targets significantly complicates prognosis and treatment planning. Among candidate biomarkers, the epidermal growth factor receptor (EGFR/ERBB1) has emerged as a promising contributor to TNBC pathobiology, with growing evidence supporting its diagnostic and therapeutic relevance.

Objective

This study aimed to assess the expression of EGFR in TNBC and to explore its relationship with key clinicopathological features and patient survival, thereby elucidating its potential role in disease progression and prognostic stratification.

Methods

A retrospective analysis was conducted on a cohort of 80 patients diagnosed with TNBC. EGFR protein expression was evaluated through immunohistochemical staining, and a semi-quantitative H-score was calculated for each case. Statistical analyses were performed to examine associations between EGFR expression and clinicopathological variables. Kaplan–Meier survival curves and Cox regression models were used to determine the prognostic significance of EGFR.

Results

EGFR expression was evaluated in 80 TNBC cases and stratified by H-score into four levels, revealing that 78% of tumors exhibited high to very high expression. Increased EGFR levels were significantly associated with larger tumor size (p = 0.0205), positive nodal status (p = 0.0233), and advanced TNM stage (p < 0.001). High EGFR expression correlated strongly with recurrence, particularly metastatic (p < 0.001), and with mortality (p < 0.001). Survival analysis showed reduced overall and disease-free survival in patients with elevated EGFR, supported by high AUC values in ROC analysis. Multivariate Cox regression confirmed EGFR as an independent prognostic factor for both OS (p = 0.013) and DFS (p = 0.006).

Conclusion

EGFR is closely linked to aggressive tumor behavior in TNBC and holds significant prognostic value. Its overexpression is indicative of worse survival outcomes and may inform treatment decisions. These findings support the incorporation of EGFR assessment into routine diagnostic workflows and highlight the need for further investigation into EGFR-targeted therapeutic strategies in TNBC.