Liu Sihua, Du Beidi, Zhou Shuling, Shao Nan, Zheng Shaoquan, Kuang Xiaying, Zhang Yunjian, Shi Yawei, Lin Ying
Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Breast Disease Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Laboratory of Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Clin Breast Cancer. 2025 Apr;25(3):242-250.e6. doi: 10.1016/j.clbc.2024.11.016. Epub 2024 Nov 26.
To characterize site-specific recurrence patterns and survival outcomes of patients with human epidermal growth factor receptor 2 (HER2)-low breast cancer.
This retrospective cohort study included patients diagnosed with early-stage breast cancer at a single institution in China from January 2010 to December 2020. Patterns of the first site of recurrence were compared between patients with HER2-low and HER2-0 tumors using competing risks regression analysis. Disease-free survival (DFS) and overall survival (OS) were evaluated using Kaplan-Meier method.
A total of 2055 patients were analyzed (median follow-up 52.3 months), comprising 1102 (53.6%) patients with HER2-low and 953 (46.4%) with HER2-0 tumors. Patients with HER2-0 tumors had a significantly higher 5-year cumulative incidence of visceral recurrence than those with HER2-low tumors (7.20% vs. 4.50%; P = .046), especially for the lung recurrence (4.16% vs. 2.81%; P = .044). In the hormone receptor (HoR)-positive subgroup, HER2-low patients had a significantly higher risk of local recurrence (10-year cumulative incidence rate, 7.58% vs. 2.61%; P = .013) but a relatively lower risk of contralateral breast cancer (10-year cumulative incidence rate, 0.90% vs. 4.53%; P = .044) compared with HER2-0 patients. Nevertheless, there were no significant differences between the HER2-0 and HER2-low patients regarding the time to all sites of recurrence after adjusting other potential risk factors (all P > .05), DFS (P = .763), and OS (P = .106).
Site-specific recurrence patterns differ between HER2-low and HER2-0 patients. However, it does not support that HER2-low breast cancer is a distinct prognostic subtype.
描述人表皮生长因子受体2（HER2）低表达乳腺癌患者的特定部位复发模式和生存结果。
这项回顾性队列研究纳入了2010年1月至2020年12月在中国一家机构被诊断为早期乳腺癌的患者。使用竞争风险回归分析比较HER2低表达和HER2零表达肿瘤患者的首个复发部位模式。采用Kaplan-Meier法评估无病生存期（DFS）和总生存期（OS）。
共分析了2055例患者（中位随访52.3个月），其中1102例（53.6%）为HER2低表达患者，953例（46.4%）为HER2零表达肿瘤患者。HER2零表达肿瘤患者的内脏复发5年累积发生率显著高于HER2低表达肿瘤患者（7.20%对4.50%；P = 0.046），尤其是肺复发（4.16%对2.81%；P = 0.044）。在激素受体（HoR）阳性亚组中，与HER2零表达患者相比，HER2低表达患者的局部复发风险显著更高（10年累积发生率，7.58%对2.61%；P = 0.013），但对侧乳腺癌风险相对较低（10年累积发生率，0.90%对4.53%；P = 0.044）。然而，在调整其他潜在风险因素后，HER2零表达和HER2低表达患者在所有部位复发时间、DFS（P = 0.763）和OS（P = 0.106）方面均无显著差异。
HER2低表达和HER2零表达患者的特定部位复发模式不同。然而，这并不支持HER2低表达乳腺癌是一种独特的预后亚型。
