Davidoff Cancer Center, Institute of Oncology, Rabin Medical Center, Petah Tikva, Israel.
Davidoff Cancer Center, Institute of Oncology, Rabin Medical Center, Petah Tikva, Israel; Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Breast. 2021 Dec;60:62-69. doi: 10.1016/j.breast.2021.08.016. Epub 2021 Aug 26.
Recent data suggest that human epidermal growth factor receptor 2 (HER2)-low breast cancer may represent a distinct entity. We aimed to compare disease characteristics and outcomes between HER2-low and HER2-0 in estrogen receptor (ER) positive, early-stage breast cancer.
A single center retrospective study comprising all women with ER positive, HER2 negative early breast cancer, for whom an Oncotype DX test was performed between 2005 and 2012. Women were grouped to HER2-low (immunohistochemistry +1 or +2 and in situ hybridization not amplified) or HER2-0. Clinico-pathological features and Oncotype recurrence score (RS) were collected. Data on overall-survival (OS), disease-free survival (DFS) and distant disease-free survival (DDFS) were evaluated according to HER2 expression status.
608 women were included, of which 304 women had HER2-0 and 304 had HER2-low disease. Lobular subtype was significantly more common in HER-0 compared to HER2-low disease (17% vs. 8%, p = 0.005). The prevalence of other clinic-pathological characteristics and long-term prognosis were comparable between both groups. For women with high genomic risk (RS > 25), HER2-low expression was associated with significantly favorable OS (HR = 0.31, 95% CI 0.11-0.78, p = 0.01), DFS (HR = 0.40, 95% CI 0.20-0.82, p = 0.01) and DDFS (HR = 0.26, 95% CI 0.11-0.63, P = 0.002) compared to women with HER2-0. For women with low genomic risk (RS ≤ 25), long-term prognosis was unrelated to HER2 expression.
The prognostic impact of HER2-low expression in early-stage luminal disease varies across the genomic risk, with significant favorable outcomes of HER2-low expression compared to HER2-0 in women with high genomic risk.
最近的数据表明，人类表皮生长因子受体 2（HER2）低表达乳腺癌可能代表一种独特的实体。我们旨在比较雌激素受体（ER）阳性早期乳腺癌中 HER2 低表达和 HER2 0 之间的疾病特征和结局。
这是一项单中心回顾性研究，纳入了 2005 年至 2012 年间所有接受 ER 阳性、HER2 阴性早期乳腺癌治疗并进行 Oncotype DX 检测的女性。将患者分为 HER2 低表达（免疫组化+1 或+2，原位杂交未扩增）或 HER2 0。收集临床病理特征和 Oncotype 复发评分（RS）。根据 HER2 表达状态评估总生存（OS）、无病生存（DFS）和远处无病生存（DDFS）数据。
共纳入 608 例女性，其中 304 例为 HER2 0，304 例为 HER2 低表达疾病。与 HER2 低表达疾病相比，HER2 0 中更常见的是小叶癌亚型（17% vs. 8%，p=0.005）。两组的其他临床病理特征和长期预后相似。对于基因组风险高（RS>25）的女性，HER2 低表达与显著的 OS（HR=0.31，95%CI 0.11-0.78，p=0.01）、DFS（HR=0.40，95%CI 0.20-0.82，p=0.01）和 DDFS（HR=0.26，95%CI 0.11-0.63，P=0.002）显著相关，而与 HER2 0 女性相比。对于基因组风险低（RS≤25）的女性，长期预后与 HER2 表达无关。
在早期 luminal 疾病中，HER2 低表达的预后影响因基因组风险而异，与 HER2 0 相比，基因组风险高的女性中 HER2 低表达的结果显著更好。
