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Clinical, Pathological Complete Response, and Prognosis Characteristics of HER2-Low Breast Cancer in the Neoadjuvant Chemotherapy Setting: A Retrospective Analysis

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The present study was conducted to evaluate the clinical, pathological response, and prognosis characteristics of human epidermal growth factor receptor 2 (HER2)-low breast cancer in the neoadjuvant chemotherapy setting.

Methods

Patients with HER2-negative breast cancer who received neoadjuvant chemotherapy from January 2017 to December 2019 were retrospectively analyzed. HER2-negative breast cancer was divided into two groups: HER2-zero (defined as immunohistochemistry [IHC] 0) and HER2-low (defined as IHC 1+, or IHC 2+ and fluorescence in-situ hybridization-negative.

Results

Overall, 314 patients with HER2-negative breast cancer were analyzed. The proportion of HER2-low patients with hormone receptor (HR)-positive disease was higher than in triple-negative breast cancer (TNBC; 75.3% vs. 63.2%, p = 0.032). In HR-positive breast cancer, HER2-low tumors presented less nodal involvement (p = 0.023) and earlier clinical stage (p = 0.015) compared with HER2-zero tumors; however, in TNBC, HER2-low patients had a later clinical stage (p = 0.028). With the pathological complete response (pCR) defined as ypTis/0ypN0, there was no difference in pCR rates among the entire cohort, HR-positive disease, and TNBC. However, with the pCR defined as ypT0ypN0, the pCR rate in HER2-low breast cancer was significantly lower than HER2-zero breast cancer in the entire cohort (24.3% vs. 36.4%, p = 0.032) and the HR-positive subgroup (18.7% vs. 32.1%, p = 0.035), but not for TNBC. Multivariate analysis demonstrated that HER2 status (low vs. zero) was an independent predictive factor for pCR (p = 0.013) in HR-positive breast cancer. There were no statistically significant differences in 3-year disease-free survival and overall survival between HER2-low and HER2-zero breast cancer among the entire cohort, HR-positive disease, and TNBC.

Conclusions

HER2-low breast cancer exhibits specific clinical features and different response to treatment associated with HR status in the neoadjuvant chemotherapy setting.

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Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

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Funding

This work was supported by the Medical Science and Technique Foundation of Henan Province (No. LHGJ20210055) and Beijing Medical Award Foundation Project (No.YXJL-2020-0941-0748).

Author information

Authors and Affiliations

  1. Department of Breast Oncology, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, China

    Yingbo Shao MS, Yang Yu MS, Fangyuan Zhu MS, Yaning He MD, Qi Chen MS, Chaojun Liu MD, Bing Nie MS & Hui Liu MD

  2. Department of Breast Oncology, Henan Provincial People’s Hospital, Henan University People’s Hospital, Zhengzhou, Henan, China

    Yingbo Shao MS, Yang Yu MS, Fangyuan Zhu MS, Yaning He MD, Qi Chen MS, Chaojun Liu MD, Bing Nie MS & Hui Liu MD

  3. Department of Medical Oncology, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, China

    Zhifen Luo MD

  4. Department of Medical Oncology, Henan Provincial People’s Hospital, Henan University People’s Hospital, Zhengzhou, Henan, China

    Zhifen Luo MD

  5. Department of Pathology, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, Zhengzhou, Henan, China

    Huijuan Guan MD

  6. Department of Pathology, Henan Provincial People’s Hospital, Henan University People’s Hospital, Zhengzhou, Henan, China

    Huijuan Guan MD

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  1. Yingbo Shao MS
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Contributions

All authors contributed to the article and approved the submitted version. Yingbo Shao and Hui Liu designed the research, analyzed the data, and drafted the paper. Yingbo Shao, Yang Yu, Zhifen Luo and Yaning He were responsible for data collection and analysis. Fangyuan Zhu, Qi Chen, Chaojun Liu and Bing Nie were primarily responsible for statistical analysis.

Corresponding author

Correspondence to Hui Liu MD.

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Disclosure

Yingbo Shao, Yang Yu, Zhifen Luo, Huijuan Guan, Fangyuan Zhu, Yaning He, Qi Chen, Chaojun Liu, Bing Nie, and Hui Liu declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Ethics statement

This study was carried out in accordance with the ethical guidelines of the 1975 Declaration of Helsinki and was approved by the Ethics Committee of Henan Provincial People’s Hospital (2021-84). Written informed consent was obtained from all patients for the use of the medical records for research purposes.

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Shao, Y., Yu, Y., Luo, Z. et al. Clinical, Pathological Complete Response, and Prognosis Characteristics of HER2-Low Breast Cancer in the Neoadjuvant Chemotherapy Setting: A Retrospective Analysis. Ann Surg Oncol 29, 8026–8034 (2022). https://doi.org/10.1245/s10434-022-12369-4

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