Ahuja Sana, Khan Adil Aziz, G Kiruthikasri, Zaheer Sufian
Department of Pathology, Safdarjung Hospital, Vardhman Mahavir Medical College, New Delhi, India.
Korean J Clin Oncol. 2024 Dec;20(2):79-83. doi: 10.14216/kjco.24011. Epub 2024 Dec 31.
Breast cancer subtypes are delineated by human epidermal growth factor receptor 2 (HER2) expression, pivotal in treatment selection. HER2-positive tumors typically respond to targeted therapies, whereas HER2-negative tumors lack HER2 overexpression. However, a subset exhibits low HER2 expression without amplification, termed HER2 low breast cancer. Despite being distinct, its clinicopathological characteristics and therapeutic implications remain less understood.
A retrospective cohort study was conducted on histologically confirmed breast cancer cases from January 2022 to December 2023. Clinicopathological data including age, tumor size, nodal involvement, and hormone receptor status were collected. Immunohistochemistry categorized tumors into luminal, triple-negative, and HER2-enriched subtypes. HER2 expression was re-evaluated, classifying tumors into HER2 low and HER2-negative based on staining intensity and amplification status. Statistical analysis was performed using SPSS software.
Seventy female patients with breast cancer were included, exhibiting diverse clinicopathological features. HER2 low tumors (40%) were significantly associated with higher tumor stage (P=0.03), nodal involvement (P=0.01), and positive androgen receptor expression (P=0.01). Subgroup analysis revealed HER2 low hormone receptor-positive cases (78.6%) were associated with higher tumor stage (P=0.01) and nodal involvement (P=0.01), while HER2 low triple-negative cases (21.4%) demonstrated distinct characteristics such as higher histological grade (P=0.02).
This study underscores the complexity of HER2 low breast cancer and its implications for clinical management, emphasizing the need for personalized treatment strategies. It provides insights into the clinicopathological parameters of HER2 low breast cancers, highlighting their diverse characteristics and clinical implications.
乳腺癌亚型通过人表皮生长因子受体2（HER2）表达来划分，这对治疗选择至关重要。HER2阳性肿瘤通常对靶向治疗有反应，而HER2阴性肿瘤不存在HER2过表达。然而，有一部分肿瘤表现为HER2低表达且无扩增，称为HER2低表达乳腺癌。尽管其具有独特性，但其临床病理特征及治疗意义仍了解较少。
对2022年1月至2023年12月组织学确诊的乳腺癌病例进行回顾性队列研究。收集包括年龄、肿瘤大小、淋巴结受累情况及激素受体状态等临床病理数据。免疫组化将肿瘤分为管腔型、三阴性和HER2富集型亚型。重新评估HER2表达，根据染色强度和扩增状态将肿瘤分为HER2低表达和HER2阴性。使用SPSS软件进行统计分析。
纳入70例女性乳腺癌患者，呈现出多样的临床病理特征。HER2低表达肿瘤（40%）与更高的肿瘤分期（P=0.03）、淋巴结受累（P=0.01）及雄激素受体阳性表达（P=0.01）显著相关。亚组分析显示，HER2低表达激素受体阳性病例（78.6%）与更高的肿瘤分期（P=0.01）和淋巴结受累（P=0.01）相关，而HER2低表达三阴性病例（21.4%）表现出不同特征，如更高的组织学分级（P=0.02）。
本研究强调了HER2低表达乳腺癌的复杂性及其对临床管理的影响，强调了个性化治疗策略的必要性。它提供了对HER2低表达乳腺癌临床病理参数的见解，突出了其多样的特征和临床意义。
