Department of Breast Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
Sci Rep. 2023 Nov 11;13(1):19669. doi: 10.1038/s41598-023-47033-8.
Adjuvant therapy for patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, node-positive, early breast cancer (EBC) remains challenging. The prognostic significance of HER2-low positivity in these patients is not fully understood. In our retrospective study, we analyzed 647 patients with HR-positive, HER2-negative, node-positive EBC, stratifying them into three cohorts based on axillary lymph node involvement, tumor size, and characteristics. Cohort 1 included patients with either ≥ 4 positive axillary lymph nodes or 1-3 positive nodes with histological grade 3 or tumor size ≥ 5 cm. Cohort 2 consisted of patients with 1-3 positive nodes, histological grade < 3, tumor size < 5 cm, and Ki-67 ≥ 20%. Cohort 3 comprised patients with 1-3 positive nodes, histological grade < 3, tumor size < 5 cm, and Ki-67 < 20%. We compared invasive disease-free survival (IDFS) and distant relapse-free survival (DRFS) between HER2-low (IHC1+ or IHC2+/FISH-) and HER2-zero (IHC0) groups in each cohort. In cohort 1, HER2-low patients exhibited significantly better 5-year IDFS (84.2% vs. 73.6%, p = 0.0213) and DRFS (88.2% vs. 79.8%, p = 0.0154). However, no significant differences were observed in cohorts 2 and 3. Our findings suggest HER2-low positivity as a prognostic factor in HR-positive, HER2-negative, and node-positive EBC.
对于激素受体（HR）阳性、人表皮生长因子受体 2（HER2）阴性、淋巴结阳性的早期乳腺癌（EBC）患者，辅助治疗仍然具有挑战性。这些患者中 HER2 低阳性的预后意义尚未完全明确。在我们的回顾性研究中，我们分析了 647 例 HR 阳性、HER2 阴性、淋巴结阳性的 EBC 患者，根据腋窝淋巴结受累、肿瘤大小和特征将他们分为三组。队列 1 包括要么有≥4 个阳性腋窝淋巴结，要么有 1-3 个阳性淋巴结且组织学分级为 3 级或肿瘤大小≥5cm 的患者。队列 2 由 1-3 个阳性淋巴结、组织学分级<3 级、肿瘤大小<5cm 和 Ki-67≥20%的患者组成。队列 3 包括 1-3 个阳性淋巴结、组织学分级<3 级、肿瘤大小<5cm 和 Ki-67<20%的患者。我们比较了每个队列中 HER2 低（免疫组化 1+或免疫组化 2+/荧光原位杂交-）和 HER2 零（免疫组化 0）组的浸润性无病生存（IDFS）和远处无复发生存（DRFS）。在队列 1 中，HER2 低患者的 5 年 IDFS（84.2% vs. 73.6%，p=0.0213）和 DRFS（88.2% vs. 79.8%，p=0.0154）显著更好。然而，在队列 2 和 3 中未观察到显著差异。我们的研究结果表明，HER2 低阳性是 HR 阳性、HER2 阴性和淋巴结阳性的 EBC 的一个预后因素。
