ArticleBreast cancer research and treatment2024
Unveiling the HER2-low phenomenon: exploring immunohistochemistry and gene expression to characterise HR-positive HER2-negative early breast cancer.
Article in Breast cancer research and treatment, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 8 citations in OpenAlex.
- Receptor discordance between primary tumors and nodal metastases and correlation with the 21-gene recurrence score in early-stage, estrogen receptor-positive, node-positive breast cancer.Breast cancer research and treatment · 2026Article
- Prognostic value of RecurIndex in differentiating HER2-low from HER2-negative early-stage breast cancer: a comprehensive clinicopathologic and molecular analysis in Chinese patients.Translational breast cancer research : a journal focusing on translational research in breast cancer · 2026Article
- HER2-Low Breast Cancer at the Interface of Pathology and Technology: Toward Precision Management.Biomedicines · 2025Review
- Illuminating the clinicopathological and genomic landscape of HER2-null, ultralow, and low breast cancers: insights into diagnostic discordance between biopsy and surgical excision.NPJ breast cancer · 2025Article
- Clinical characteristics and prognostic impact of HER2-ultralow breast cancer and tumor-infiltrating lymphocytes (TILs).BMC cancer · 2025Article
- Changes in HER2low and HER2-ultralow status in 47 advanced breast carcinoma core biopsies, matching surgical specimens, and their distant metastases assessed by conventional light microscopy, digital pathology, and artificial intelligence.Breast cancer research and treatment · 2025Article
- Identifying low-risk breast cancer patients for axillary biopsy exemption: a multimodal preoperative predictive model.European journal of medical research · 2025Article
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8 authors at 1 institution in 1 country.
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Abstract
purposeHER2-low breast cancer (BC) is a novel entity with relevant therapeutic implications, especially in hormone receptor (HR) positive BC. This study examines whether HER2 mRNA through the 21-gene assay, Oncotype DX (ODX), can refine the diagnosis of HER2-low and HER2-zero, obtained by immunohistochemistry (IHC).
methodsBetween Jan 2021 and Jan 2023, 229 consecutive HR-positive HER2-negative early BC (T1-3 N0-1) have been characterised by IHC and ODX. HER2 status by IHC was either zero (IHC-0) or low (IHC-1 + and IHC-2 + /ISH-negative) while HER2-zero was further divided into HER2-null (IHC-0) and HER2-ultralow (IHC-1-10%). HER2 gene expression by ODX was negative if lower 10.7.
resultsThe distribution of HER2 IHC was as follows: 53.3% HER2-0, 29.25% HER2-1 + , and 17.5% HER2-2 + . The clinicopathological characteristics were similar in the three groups, with higher PgR-negative rate in HER2-zero (13.9% vs 3% vs 5%). The distribution of RS was homogeneous in the three groups with the median HER2 gene expression of 9.20 [IQR: 8.70-9.60]. HER2 gene expression gradually increased as the IHC score, with substantial overlap. After adjusting for confounders, HER2-1 + and HER2 2 + had a significant positive correlation between HER2 gene expression and IHC [OR 1.42, 95% CI 1.21 to 1.68, p < 0.001; OR 1.96, 95% CI 1.61 to 2.37, p < 0.001] compared to the HER2-zero group. HER2 gene expression did not differ between HER2-null and HER2-ultralow subgroups.
conclusionDue to the substantial overlap, the HER2 gene expression is unable to properly distinguish HER2-low and HER2-zero IHC whose accurate identification is critical in the context of HER2-negative BC.
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