A nomogram to predict HER2 status in breast cancer patients with HER2-borderline disease as determined via immunohistochemistry

Guo, Qianqian; Chen, Kai; Lin, Xi Victoria; Su, Yi; Xu, Rui; Dai, Yan; Qiu, Chen; Xue, Song; Mao, Siying; Chen, Qianjun

doi:10.18632/oncotarget.19313

Cited by 6 publications

(15 citation statements)

References 43 publications

(32 reference statements)

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“…The prevalence of HER2 positivity in borderline HER2 in our study was similar to a large cohort of patients in India, which was estimated as 14.6% [5]. However, in numerous studies, the rate of HER2 ampli cation by FISH in IHC borderline tumors was higher than the present study, from 27.5% to 70 % [10][11][12][13][14]. The reason for such a high reported rate was explained in some of the publications.…”

Section: Discussionsupporting

confidence: 83%

The Prevalence of HER2 Positivity In HER2 Borderline Tumors In Iranian Breast Cancer Patients And Predictive Variables

Omranipour¹,

Nazarian²,

Alipour³

et al. 2021

Preprint

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Background: Human epidermal growth receptor-2 (HER2) gene amplification is an important predictive and prognostic factor in breast cancer treatment. However, the expression of HER2 by immunohistochemistry (IHC) is determined as borderline in some cases and confirmation of the HER2 status by in situ hybridization either fluorescent (FISH) or bright field chromogenic (CISH) is necessary for correct treatment decision-making. Considering the high cost of FISH and CISH, we aimed to investigate whether the HER2 status could be predicted by other histological and cellular characteristics of the tumor by evaluating the association of these characteristics with the actual tumor HER2 status. Methods: Data of 438 breast cancer patients with IHC-determined HER-2 borderline disease was evaluated retrospectively. FISH or CISH results, pathologic tumor size and type, node involvement, Ki67%, presence of estrogen and progesterone receptor (ER, PR), HER2 status, lymphovascular invasion (LVI), perineural invasion (PNI), and stage were retrieved from clinic records. Results: Seventy-four (16.9%) patients had positive results for HER2 status with FISH or CISH. Logistic regression analysis showed that the pathologic size had a positive association with HER2 positivity with an OR equal to 1.03 (Odds ratio (OR):1.03, 95% CI: 1.01-1.05). In addition, the adjusted OR illustrated a statistically significant association between HER2 positivity and PR negativity (OR=2.14, 95% CI: 1.14-4.02). The invasive lobular carcinoma histology had a reverse association with HER2 positive status, with a borderline significance level (OR=0.15, 95% CI: 0.02-1.18).Conclusion: We could not find an applicable model to predict the actual status of HER2 in borderline cases and still, we have to recommend further assay by FISH or CISH in these patients.

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Section: Discussionsupporting

confidence: 83%

The Prevalence of HER2 Positivity In HER2 Borderline Tumors In Iranian Breast Cancer Patients And Predictive Variables

Omranipour¹,

Nazarian²,

Alipour³

et al. 2021

Preprint

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“…A radiomics nomogram was established incorporating ER status and com-rad-score. The nomogram yielded an AUC of 0.848 in the validation cohort, which was higher than that of previous nomograms for HER-2 2+ status determination that only used clinicopathologic characteristics of BC (AUC: 0.749) [6]. The nomogram also achieved a higher AUC than the com-rad-score.…”

Section: Discussionmentioning

confidence: 68%

“…According to IHC results, a HER-2 staining intensity score of 3+ is considered positive, whereas a score of 0 or 1+ is considered negative. However, IHC cannot identify HER-2 2+ status, which accounted for approximately 17% of HER-2 patients [6], and a fluorescence in-situ hybridization (FISH) assay is required. Identification of gene amplification via FISH classifies tumors into positive or negative according to the HER-2 2+ status.…”

Section: Introductionmentioning

confidence: 99%

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Radiomics Nomogram Based on Radiomics Score from Multiregional Diffusion-Weighted MRI and Clinical Factors for Evaluating HER-2 2+ Status of Breast Cancer

Yin

2021

Diagnostics

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This study aimed to establish and validate a radiomics nomogram using the radiomics score (rad-score) based on multiregional diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) features combined with clinical factors for evaluating HER-2 2+ status of breast cancer. A total of 223 patients were retrospectively included. Radiomic features were extracted from multiregional DWI and ADC images. Based on the intratumoral, peritumoral, and combined regions, three rad-scores were calculated using the logistic regression model. Independent parameters were selected among clinical factors and combined rad-score (com-rad-score) using multivariate logistic analysis and used to construct a radiomics nomogram. The performance of the nomogram was evaluated using calibration, discrimination, and clinical usefulness. The areas under the receiver operator characteristic curve (AUCs) of intratumoral and peritumoral rad-scores were 0.824/0.763 and 0.794/0.731 in the training and validation cohorts, respectively. Com-rad-score achieved the highest AUC (0.860/0.790) among three rad-scores. ER status and com-rad-score were selected to establish the nomogram, which yielded good discrimination (AUC: 0.883/0.848) and calibration. Decision curve analysis demonstrated the clinical value of the nomogram in the validation cohort. In conclusion, radiomics nomogram, including clinical factors and com-rad-score, showed favorable performance for evaluating HER-2 2+ status in breast cancer.

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“…Study from Morocco which included 1508 patients found that overexpression of HER2 was associated with high tumor grade, vascular space invasion and ER negativity significantly [21]. Another study from a single center in China suggested that ER status, PR status and tumor grade were significantly associated with HER2 status [22]. Different studies from different institution indicated the same finding that HER2 overexpression is correlated with HR negativity, while the relationship between HER2 expression and other clinicopathologic parameters varies, such as tumor dimension, nodal involvement and tumor grading.…”

Section: Discussionmentioning

confidence: 99%

A nomogram for predicting the HER2 status in female patients with breast cancer in China: a nationwide, multicenter, 10-year epidemiological study

Zhang

Xie

et al. 2019

Diagn Pathol

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Background The concordance rate of human epidermal growth factor receptor 2 (HER2) status between core needle biopsy (CNB) and subsequent excisional biopsies of the same tumor varies from 81 to 96%, which may cause inappropriate neoadjuvant therapy that impair the potential benefit from HER2 targeted therapy for patients. This study aimed to establish a nomogram to predict the HER2 status pre-operatively as an auxiliary diagnosis to CNB assessment. Methods Among 4211 breast cancer patients cataloged in the Nation-wide Multicenter 10-year Retrospective Clinical Epidemiological Study of Breast Cancer in China, 2291 patients with complete relevant information were included in this study, which were further randomized 3:1 and divided into a training set and a validation set. The nomogram was established based on independent predictors of HER2 positivity recognized by logistic regression analysis and further validated internally and externally. Results The multivariate logistic regression analysis showed that T-stage, N-stage, estrogen receptor (ER) status, progesterone receptor (PR) status were independent predictors for HER2 status. The nomogram was thereby constructed by those independent predictors as well as histology type. The areas under the receiver operating characteristic curve (AUC) of the training set and the validation set were 0.636 and 0.681, respectively. The calibration plots demonstrated good fitness of the nomogram for HER2 status prediction. With the optimal cutoff value, the nomogram yielded 80.0% sensitivity, 43.1% specificity in the training set and 81.1% sensitivity, 49.8% specificity in the validation set. Conclusions The present nomogram can provide valuable information on HER2 status and combined with standard CNB assessment, clinicians could make more appropriate decision on neoadjuvant therapy of breast cancer. Electronic supplementary material The online version of this article (10.1186/s13000-019-0806-4) contains supplementary material, which is available to authorized users.

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A nomogram to predict HER2 status in breast cancer patients with HER2-borderline disease as determined via immunohistochemistry

Cited by 6 publications

References 43 publications

The Prevalence of HER2 Positivity In HER2 Borderline Tumors In Iranian Breast Cancer Patients And Predictive Variables

The Prevalence of HER2 Positivity In HER2 Borderline Tumors In Iranian Breast Cancer Patients And Predictive Variables

Radiomics Nomogram Based on Radiomics Score from Multiregional Diffusion-Weighted MRI and Clinical Factors for Evaluating HER-2 2+ Status of Breast Cancer

A nomogram for predicting the HER2 status in female patients with breast cancer in China: a nationwide, multicenter, 10-year epidemiological study

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