HER2-low breast cancer: evolution of HER2 expression from primary tumor to distant metastases

Cai, Mengyuan; Li, Ming; Lv, Hong; Zhou, Shuling; Xu, Xiaohua; Shui, Ruo Hong; Yang, Wentao

doi:10.1186/s12885-023-11134-4

Cited by 4 publications

(1 citation statement)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous studies showed that molecular characteristics can vary between the primary tumor (PT) and distant metastases [ 12 , 13 , 14 ]. More specifically, discrepancies in HER2 expression between the PT and metastases could be shown in almost 50% of cases [ 15 , 16 ]. In addition to tumor plasticity [ 17 ], another explanation for these differences may be that early spreading cells differ from the PT or that specific subclones from the PT have a higher tendency to metastasize [ 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Comparing the HER2 Status of the Primary Tumor to That of Disseminated Tumor Cells in Early Breast Cancer

Volmer,

Dannehl,

Matovina

et al. 2024

IJMS

View full text Add to dashboard Cite

Breast cancer remains a leading cause of cancer mortality in women globally. Despite advancements in systemic therapy, the risk of distant recurrence persists even after such treatment and may be linked to disseminated tumor cells (DTCs). Variability in molecular characteristics between primary tumors (PTs) and distant metastases underscores the need to comprehensively understand metastatic pathways. This retrospective study investigated discrepancies between HER2 expression in PTs and DTCs and their implications for survival outcomes in 201 early breast cancer (EBC) patients. We found a significant association between HER2 expression in PTs and DTCs when classifying tumors as HER2-high/low/negative. Patients whose HER2 status was discordant between PTs and DTCs exhibited worse distant disease-free survival than those with concordant status. Multivariate analysis confirmed the HER2 status of DTCs as an independent prognostic factor for distant DFS. These findings emphasize the importance of assessing HER2 expression in DTCs and its potential implications for tailored therapy strategies in EBC. Furthermore, prospective trials are needed to validate these findings and explore targeted therapies based on the molecular characteristics of DTCs.

show abstract

Section: Introductionmentioning

confidence: 99%

Comparing the HER2 Status of the Primary Tumor to That of Disseminated Tumor Cells in Early Breast Cancer

Volmer,

Dannehl,

Matovina

et al. 2024

IJMS

View full text Add to dashboard Cite

show abstract

Interobserver Variability in HER‐2 Immunostaining Interpretation of Metastatic HER2 Low Breast Cancers in Cytology Specimens

Desai,

Connelly,

Sung

et al. 2024

Diagnostic Cytopathology

View full text Add to dashboard Cite

BackgroundApproximately, 55% of breast carcinomas are reported to be HER‐2 low breast carcinomas. Trastuzumab‐Deruxtecan is a new FDA‐approved targeted therapy for HER‐2 low metastatic breast carcinomas, making it essential that all efforts are made to identify these tumors in specimens submitted for pathologic examination. Cytology specimens are often the first and only modality of this assessment due to the ease of specimen procurement. This study aimed to determine the variability in HER‐2 immunostaining interpretation among observers using cytologic specimens from metastatic sites.DesignA pathology database search was made to identify metastatic breast carcinoma reported in cytology specimens. A manual search was then done to identify cases of HER‐2 low category, H&E cell block and HER‐2 neu immunostain slides were retrieved for a total of 50 cases. Reviewer #1 and #2 independently interpreted HER‐2 immunostain of all 50 cases. Only discordant cases were sent for reviewer‐3 interpretation. All three were blinded by the metastatic site, and original HER‐2 interpretation.ResultsOf 50 cases, 11 cases (22%) were reported as concordant scores between reviewer #1 and reviewer #2 but had a discordant original IHC report. Additionally, 4 cases (8%) had discordant reporting of HER2 IHC stain between reviewer #1 and reviewer #2 making a total of 15 cases (30%) with overall discordant results.ConclusionThis study highlights the interobserver variability of HER‐2 immunostain interpretation for HER‐2 low category of breast carcinomas. We recommend the need for more robust laboratory techniques including molecular for uniform identification of these unique targetable metastatic breast carcinoma groups.

show abstract

A population-based study on trajectories of HER2 status during neoadjuvant chemotherapy for early breast cancer and metastatic progression

Boman,

Liu,

Eriksson Bergman

et al. 2024

Br J Cancer

View full text Add to dashboard Cite

Background This study aimed to investigate the distribution and changes of HER2 status in untreated tumours, in residual disease and in metastasis, and their long-term prognostic implications. Methods This is a population-based cohort study of patients treated with neoadjuvant chemotherapy for breast cancer during 2007–2020 in the Stockholm–Gotland region which comprises 25% of the entire Swedish population. Information was extracted from the National Breast Cancer Registry and electronic patient charts to minimize data missingness and misclassification. Results In total, 2494 patients received neoadjuvant chemotherapy, of which 2309 had available pretreatment HER2 status. Discordance rates were 29.9% between primary and residual disease (kappa = 0.534), 31.2% between primary tumour and metastasis (kappa = 0.512) and 33.3% between residual disease to metastasis (kappa = 0.483). Adjusted survival curves differed between primary HER2 0 and HER2-low disease (p < 0.001), with the former exhibiting an early peak in risk for death which eventually declined below the risk of HER2-low. Across all disease settings, increasing the number of biopsies increased the likelihood of detecting HER2-low status. Conclusion HER2 status changes during neoadjuvant chemotherapy and metastatic progression, and the long-term behaviours of HER2 0 and HER2-low disease differ, underscoring the need for obtaining tissue biopsies and for extended follow-up in breast cancer studies.

show abstract

HER2-low breast cancer: evolution of HER2 expression from primary tumor to distant metastases

Cited by 4 publications

References 47 publications

Comparing the HER2 Status of the Primary Tumor to That of Disseminated Tumor Cells in Early Breast Cancer

Comparing the HER2 Status of the Primary Tumor to That of Disseminated Tumor Cells in Early Breast Cancer

Interobserver Variability in HER‐2 Immunostaining Interpretation of Metastatic HER2 Low Breast Cancers in Cytology Specimens

A population-based study on trajectories of HER2 status during neoadjuvant chemotherapy for early breast cancer and metastatic progression

Contact Info

Product

Resources

About