ArticleBreast cancer research : BCR2024
Differentiating HER2-low and HER2-zero tumors with 21-gene multigene assay in 2,295 h + HER2- breast cancer: a retrospective analysis.
Article in Breast cancer research : BCR, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers.
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9 citing papers in PubMed.
- Anticancer Potential of Cherry Extracts and Major Flavonols: Focus on Quercetin and Kaempferol Molecular Mechanisms in Breast Cancer.International journal of molecular sciences · 2026Review
- Tumour-infiltrating lymphocytes differ across MammaPrint® classifications in breast cancer.Endocrine-related cancer · 2026Article
- Limits of substitution and context-dependent selective omission of Oncotype DX recurrence score testing.Breast cancer (Tokyo, Japan) · 2026Review
- Correlation of HER2 levels expression through HER2 mRNA PCR vs immunohistochemistry (IHC) in hormone receptor positive (HR+)/HER2 negative (HER2-) early breast cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Article
- HER2-Low Breast Cancer at the Interface of Pathology and Technology: Toward Precision Management.Biomedicines · 2025Review
- Enhancing HER2-low breast cancer detection with quantitative transcriptomics.NPJ breast cancer · 2025Article
- HER2 testing: evolution and update for a companion diagnostic assay.Nature reviews. Clinical oncology · 2025Review
- Deviating HER2 status between primary breast carcinomas and their liver metastases.Frontiers in oncology · 2025Article
- Efficacy and safety of Eribulin-based chemotherapy in HER2 negative advanced breast cancer patients: a real-world study.Frontiers in oncology · 2025Article
Corrections and comments
- Erratum issued
Authors and funding
11 authors.
Funding
Abstract
backgroundHER2-positivity is an essential marker for therapeutic decisions, while HER2 expression is heterogenous. In recent years, there has been increasing recognition of a subgroup of breast cancer patients who have low levels of HER2 expression, also known as HER2-low because trastuzumab deruxtecan offers clinical benefit for patients with HER2-low metastatic breast cancer. Despite the growing interest in HER2-low breast cancer, there is limited research on how multigene assays can help differentiate between HER2-low and HER2-negative breast cancer. Among HR + HER2- breast cancer, we compared genomic characteristics between HER2-low and HER2-zero using the 21-gene assay.
methodsA retrospective review of clinical records was performed in 2,295 patients who underwent Oncotype DX
resultsOf these, 944 (41.1%) patients were assigned to the HER2-zero group, while 1351 (58.9%) patients were assigned to the HER2-low group. The average Recurrence Score (RS) was found to be 17.802 in the HER2-zero breast cancer group and 18.503 in the HER2-low group, respectively (p-value < 0.005). When comparing the proportion of high RS between the two groups, the HER2-zero group had a high RS rate of 12.4% (117 out of 944), while the HER2-low group had a high RS rate of 17.0% (230 out of 1351) (p = 0.002). The HER2 score identified by qRT-PCR was 8.912 in the HER2-zero group and 9.337 in the HER2-low group (p < 0.005). In multivariable analysis, HER2-low status was found to be an independent factor for high RS, with an odds ratio of 1.517 (1.172-1.964), independent of ER, PR, and Ki67. Within the subgroup of patients with invasive ductal carcinoma, the high RS rates were 19% in the HER2-low group and 14% in the HER2-zero group. However, when considering all patients, there were no significant differences observed in recurrence-free survival and overall survival between the HER2-low and HER2-zero groups.
conclusionWithin HR + HER2- breast cancer, HER2-low tumors are associated with high RS, especially for histologically invasive ductal carcinoma. A prognostic influence of HER2-low expression among HR + HER2- breast cancer remains as an area that requires further study.
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