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ArticleBreast cancer research : BCR2025

Prevalence and concordance of HER2-low and HER2-ultralow status between historical and rescored results in a multicentre study of breast cancer patients in China.

Hong Lv, Junqiu Yue, Qingfu Zhang, Fangping Xu, Peng Gao, Haifeng Yang, Xiu Nie, Lingfei Kong, Guanjun Zhang, Jianming Li and 9 more

Registry-linked trialAbstract readMulticenter Study
In one paragraph

Article in Breast cancer research : BCR, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05203458 (HER2 Retrospective Epidemiology Study Prevalence and Clinicopathologic Features of Different HER2 Level in Chinese Breast Cancer Patients), which is not on this map. Cited by 11 papers.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05203458 completednot on this map

HER2 Retrospective Epidemiology Study Prevalence and Clinicopathologic Features of Different HER2 Level in Chinese Breast Cancer Patients (HER2 PATH)

TypeobservationalSponsorAstraZenecaRan2022 to 2023Enrolled3,136ConditionsBreast Cancer, HER2
3 · Its place in the literature

Who cites it

11 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Review
  5. Redefining breast cancer: therapeutic opportunities in HER2-low and emerging molecular subtypes.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Review
  6. Article
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Hong LvDepartment of Pathology, Fudan University Shanghai Cancer Center, 270 Dongan Rd, 270, Xuhui District, Shanghai, 200032, China.
Junqiu YueDepartment of Pathology, Hubei Cancer Hospital, Wuhan, Hubei, China.
Qingfu ZhangDepartment of Pathology, The First Hospital of China Medical University, Shenyang, China.
Fangping XuDepartment of Pathology, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China.
Peng GaoDepartment of Pathology, Qilu Hospital of Shandong University, Shandong, China.
Haifeng YangDepartment of Pathology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.
Xiu NieDepartment of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Lingfei KongDepartment of Pathology, Henan Provincial People's Hospital, Henan, China.
Guanjun ZhangDepartment of Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China.
Jianming LiDepartment of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Shiwei XiaoDepartment of Pathology, Hubei Cancer Hospital, Wuhan, Hubei, China.
Hongmei WuDepartment of Pathology, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China.
Aiyan XingDepartment of Pathology, Qilu Hospital of Shandong University, Shandong, China.
Min HongDepartment of Pathology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China.
Jun FanDepartment of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
Huijuan GuanDepartment of Pathology, Henan Provincial People's Hospital, Henan, China.
Peilong CaoDepartment of Pathology, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China.
Hengli NiDepartment of Pathology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.
Wentao YangDepartment of Pathology, Fudan University Shanghai Cancer Center, 270 Dongan Rd, 270, Xuhui District, Shanghai, 200032, China. yangwt2000@163.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccurately assessing HER2-low (immunohistochemistry [IHC] 1 + and IHC 2+/in situ hybridization [ISH]-) and HER2-ultralow (IHC > 0 < 1+) is essential given the emergence of novel therapies. Thorough understanding of the reproducibility of rescoring IHC stained slides or re-staining archived tissue slides is essential.

methods2,869 breast cancer patients diagnosed between July 2021 and July 2022 from 10 hospitals in China were included in this multicentre study. The prevalence of different HER2 expression levels and distribution of HER2 IHC scores were assessed by HER2 status determination from rescored historical slides. Concordance was evaluated across historical results versus rescored results, historical results versus re-stained results, and leading center results versus local site results. Clinicopathological characteristics were retrospectively analyzed as well.

resultsHER2 IHC 0, IHC 1+, IHC 2+, and IHC 3 + were identified in 682 (23.8%), 871 (30.4%), 801 (27.9%), and 515 (18.0%) cases, respectively. HER2-positive, HER2-low, and HER2 IHC 0 (HER2-ultralow and IHC null) were identified in 21.7%, 54.5%, and 23.8% of cases, respectively. The prevalence of HER2-ultralow and IHC null was 10.6% and 13.2%, respectively. The concordance for HER2-ultralow was 43.3%; 30% of cases that were scored as HER2-ultralow at local sites were rescored as HER2-null and 26.7% of cases were rescored as IHC 1 + at the leading site. Overall, there was substantial agreement (83.1%) between rescored and historical IHC results. A high concordance rate of 91.7% was observed for HER2-low classification.

conclusionsThis is the first multicenter study to determine the prevalence of HER2-low and HER2-ultralow based on rescored results in the Chinese breast cancer population. The concordance analysis carries important implications for the diagnosis of HER2-low and HER2-ultralow cases in clinical practice. The relatively low concordance in identifying HER2-ultralow suggested that the reproducibility of scoring HER2-ultralow needed to be improved through training.

trial registrationClinicalTrials.gov identifier NCT05203458.

Indexed as

Biomarkers, TumorBreast NeoplasmsErb-b2 Receptor Tyrosine KinasesAdultAgedAged, 80 and overChinaFemaleHumansImmunohistochemistryMiddle AgedPrevalenceReproducibility of ResultsRetrospective StudiesBiomarkers, TumorERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesBreast cancerConcordance, HER2-lowHER2-ultralowPrevalence

Identifiers

PMID40134013
PMCPMC11934669

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.