Pathologic complete response rate according to HER2 detection methods in HER2-positive breast cancer treated with neoadjuvant systemic therapy Journal Article


Authors: Krystel-Whittemore, M.; Xu, J.; Brogi, E.; Ventura, K.; Patil, S.; Ross, D. S.; Dang, C.; Robson, M.; Norton, L.; Morrow, M.; Wen, H. Y.
Article Title: Pathologic complete response rate according to HER2 detection methods in HER2-positive breast cancer treated with neoadjuvant systemic therapy
Abstract: Purpose: Human epidermal growth factor receptor 2 (HER2)-positive breast cancers are known to have significant clinical and pathological response to neoadjuvant systemic therapy (NST). The aim of this study was to identify factors associated with pathological complete response (pCR), defined as no residual invasive carcinoma in the breast and axillary lymph nodes (ypT0/is ypN0), among patients with HER2-positive breast cancer and to compare pCR rates between breast cancers with HER2 protein overexpression by immunohistochemistry (IHC) versus HER2 gene amplification by fluorescence in situ hybridization (FISH) in the absence of protein overexpression by IHC. Methods: We conducted a retrospective review of HER2-positive breast cancer patients treated with NST and surgery at Memorial Sloan Kettering Cancer Center between January 2013 and May 2018. Estrogen receptor (ER), progesterone receptor (PR), and HER2 status were assessed according to the 2018 ASCO/CAP guidelines. Results: During the study period, 560 patients were identified. Of 531 patients with IHC results available, 455 patients had HER2 IHC 3+, and 76 had IHC < 3+ but HER2 amplification detected by FISH. The overall pCR rate was 59% (330/560). The pCR rate among patients with HER2 protein overexpression (IHC 3+) was 67%, compared to 17% among patients with HER2 amplification by FISH (IHC < 3+). On univariate and multivariate analyses, HER2 protein overexpression by IHC (IHC 3+) was a significant predictor of pCR, along with grade 3 histology, PR-negative status, and dual anti-HER2 therapy. Conclusion: Although both HER2 IHC and FISH are standard HER2 testing methods in breast cancer, achievement of pCR is associated with HER2 IHC expression level, among other factors. © 2019, Springer Science+Business Media, LLC, part of Springer Nature.
Keywords: human epidermal growth factor receptor 2; pathologic complete response; her2-positive breast cancer; her2 assessment; neoadjuvant systemic therapy
Journal Title: Breast Cancer Research and Treatment
Volume: 177
Issue: 1
ISSN: 0167-6806
Publisher: Springer  
Date Published: 2019-08-01
Start Page: 61
End Page: 66
Language: English
DOI: 10.1007/s10549-019-05295-9
PUBMED: 31144151
PROVIDER: scopus
PMCID: PMC6640097
DOI/URL:
Notes: Review -- Source: Scopus
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MSK Authors
  1. Sujata Patil
    395 Patil
  2. Monica Morrow
    463 Morrow
  3. Larry Norton
    606 Norton
  4. Mark E Robson
    391 Robson
  5. Chau Dang
    170 Dang
  6. Yong Hannah Wen
    125 Wen
  7. Edi Brogi
    312 Brogi
  8. Dara Stacy Ross
    46 Ross
  9. Jin Xu
    1 Xu