Do HER2-low tumors have a distinct clinicopathologic phenotype? Journal Article
| Authors: | Polidorio, N.; Montagna, G.; Sevilimedu, V.; Le, T.; Morrow, M. |
| Article Title: | Do HER2-low tumors have a distinct clinicopathologic phenotype? |
| Abstract: | Background: Breast cancer subtypes, distinguished by hormone receptor (HR) and HER2 status, have different clinicopathologic features. With recognition of the clinical relevance of HER2-low, there is debate as to whether this is a distinct subtype. Our study aimed to determine whether HER2-low breast cancers have specific clinicopathologic features that differ from those of HER2-negative and HER2-positive cancers. Patients and Methods: A total of 11,072 patients undergoing upfront surgery from 1998 to 2010 were identified from a single-institution prospectively maintained database. HER2 status was classified by immunohistochemistry (IHC)/fluorescence in situ hybridization (FISH) as HER2 negative (41.2%), HER2 low (45%; IHC 1+ or 2+ with negative FISH), and HER2 positive (13.7%), and stratified by HR status. Univariate (UVA) and multivariable multinomial logistic regression analysis (MVA) were performed to determine associations among variables and subtypes. Results: Compared with HER2-negative tumors, HER2 low was associated with lymphovascular invasion [odds ratio (OR) 1.2, 95% confidence interval (CI) 1.06–1.36; p = 0.003], multifocality (OR 1.26, 95% CI 1.12–1.42; p < 0.001), nodal micrometastasis (OR 1.15, 95% CI 1.02–1.31; p = 0.024), and lower rates of ≥ 3 positive nodes (OR 0.77, 95% CI 0.66–0.90, p = 0.001). When stratified by HR expression, in both HR-positive and HR-negative tumors, age and multifocality were associated with HER2 low on UVA. On MVA, no variables were independently associated with both HR-negative and HR-positive/HER2-low tumors compared with HER2-negative tumors. In contrast, HER2-positive tumors, regardless of HR status, were associated with multifocality and an extensive intraductal component. Conclusion: Clinicopathologic features of HER2-low tumors appear to be primarily related to HR status. Our findings do not support the characterization of HER2 low as a separate subtype. © Society of Surgical Oncology 2023. |
| Keywords: | genetics; phenotype; metabolism; in situ hybridization, fluorescence; breast cancer; epidermal growth factor receptor 2; breast neoplasms; fluorescence in situ hybridization; breast tumor; receptor, erbb-2; receptors, estrogen; estrogen receptor; her2; subtype; lymphovascular invasion; breast cancer surgery; humans; human; female; her2-low |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 31 |
| Issue: | 4 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2024-04-01 |
| Start Page: | 2231 |
| End Page: | 2243 |
| Language: | English |
| DOI: | 10.1245/s10434-023-14800-w |
| PUBMED: | 38158494 |
| PROVIDER: | scopus |
| PMCID: | PMC11177575 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK authors: Monica Morrow -- Source: Scopus |
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