Akay Seval, Emiroglu Mumin, Kelten Talu Canan, Unal Olcun Umit
Department of Medical Oncology, Izmir City Hospital, Izmir 35540, Turkey.
Department of Pathology, Izmir Tepecik Education and Research Hospital, Izmir 35020, Turkey.
Medicina (Kaunas). 2025 Apr 13;61(4):719. doi: 10.3390/medicina61040719.
: A recent clinical trial has demonstrated that breast cancer with low-HER2 expression levels responds to trastuzumab deruxtecan treatment. This has prompted a re-evaluation of HER2-targeted therapies in the HER2-negative group. Further research is required in the form of more detailed information about HER2-negative breast cancers with HER2-null, HER2-ultralow, and HER2-low subgroups. This study represents a novel approach to this field. : HER2-negative breast cancer patients were classified into three groups as HER2-null, HER2-ultralow, and HER2-low. A comparison of clinicopathological features was analyzed retrospectively. : Of 722 patients, 22.3% were HER2-null, 23.7% were HER2-ultralow, 54.0% were HER2-low. While two-thirds of all the patients were evaluated as having T2 tumors, T4 tumors constituted 2.4%. Among HER2-negative cases, 11.8% were triple-negative and 88.2% were hormone-positive. The mean tumor diameter was 0.57 cm larger in the HER2-ultralow group than in the HER2-null group and 0.34 cm larger in the HER2-low group than in the HER2-null group. HER2-null tumors tend to be smaller. The HER2-low group was more likely to relapse than the HER2-null group. There were no significant differences in the distribution of hormone positivity or negativity (TNBC) among the groups; they accounted for 89.2% and 10.8% of all cases, respectively. : HER2-negative breast cancer is a heterogeneous disease and deserves a detailed review in terms of diagnosis and treatment. HER2-ultralow tumors are larger in size and have a prognosis comparable to HER2-null tumors. HER2-low tumors tend to recur much more frequently and with poorer outcomes. In this field, new therapeutic approaches may result in better outcomes.
一项近期的临床试验表明，HER2表达水平低的乳腺癌对曲妥珠单抗德鲁昔单抗治疗有反应。这促使人们对HER2阴性组中的HER2靶向治疗进行重新评估。需要通过获取有关HER2阴性、HER2超低和HER2低亚组的HER2阴性乳腺癌的更详细信息来开展进一步研究。本研究代表了该领域的一种新方法。
HER2阴性乳腺癌患者被分为HER2阴性、HER2超低和HER2低三组。对临床病理特征进行了回顾性分析。
在722例患者中，22.3%为HER2阴性，23.7%为HER2超低，54.0%为HER2低。虽然所有患者中有三分之二被评估为患有T2肿瘤，但T4肿瘤占2.4%。在HER2阴性病例中，11.8%为三阴性，88.2%为激素阳性。HER2超低组的平均肿瘤直径比HER2阴性组大0.57 cm，HER2低组比HER2阴性组大0.34 cm。HER2阴性肿瘤往往较小。HER2低组比HER2阴性组更易复发。各组之间激素阳性或阴性（三阴性乳腺癌）的分布无显著差异；它们分别占所有病例的89.2%和10.8%。
HER2阴性乳腺癌是一种异质性疾病，在诊断和治疗方面值得进行详细综述。HER2超低肿瘤体积更大，预后与HER2阴性肿瘤相当。HER2低肿瘤往往复发频率更高，预后更差。在该领域，新的治疗方法可能会带来更好的结果。
