Moderate HER2 expression as a prognostic factor in hormone receptor positive breast cancer

Abstract

Overexpression and/or amplification of human epidermal growth factor receptor 2 (HER2) is associated with poor prognosis in breast cancer and predicts response to anti-HER2 therapy in breast cancer. The prognostic relevance of moderate expression of HER2 is unclear. Data of 9872 patients with primary nonmetastatic breast cancer from the cancer registries of Magdeburg and Halle, Germany, were analyzed retrospectively. A total of 5907 patients with complete data sets including follow-up were eligible for analysis. HER2 status was determined as recommended by international guidelines. Of 5907 patients investigated, 5023 (68.4%) had HER2 0 and 1C expression and 884 (12.0%) had HER2 (2C)/ HER2K expression. Patients with hormone receptor positive (HRC) and HER2 (2C) tumors had a shorter median disease-free survival (DFS; P!0.0001) and breast cancer specific survival (BCSS; PZ0.019) than HRC patients with HER2 (0/1C) tumors. Among patients with HRK breast cancer there was no significant difference between HER2 (2C) and HER2 (0/1C) tumors. In multivariate analysis after adjustment for other prognostic factors, HER2 (2C) status remained an unfavorable prognostic factor for DFS (hazard ratio (HR)Z1.217, 95% CIZ1.052-1.408; PZ0.008) but not for BCSS (HRZ1.045, 95% CIZ0.926-1.178; PZ0.474). The HER2 (2C) status is an unfavorable prognostic factor for survival of patients with HRC breast cancer. The impact of anti-HER2 therapy in this group of patients should be evaluated.

The assessment of 8th edition AJCC prognostic staging system and a simplified staging system for breast cancer: The analytic results from the SEER database

“…In addition to T and N stage, many studies emphasized the prognostic significance of tumor biological characteristics such as ER, PR, and Her‐2 for BC patients . The single anatomic TNM staging might not be enough to reflect the prognosis of all BC patients and draw up subsequent treatment decision.…”

“…In addition to T and N stage, many studies emphasized the prognostic significance of tumor biological characteristics such as ER, PR, and Her-2 for BC patients. [6][7][8] The single anatomic TNM staging might not be enough to reflect the prognosis of all BC patients and draw up subsequent treatment decision. To provide more accurate prognostic information for BC patients, the novel prognostic staging system was proposed by AJCC in October 2016, in which ER, PR, Her-2, and histological grade were incorporated into the anatomic TNM staging.…”

“…The staging system could reveal the anatomic information of tumor and extent of diseases, and it was revised and improved periodically to reflect most up‐to‐date clinical progress and widespread consensus . In addition to these clinicopathologic factors, estrogen receptor (ER), progesterone receptor (PR), the expression of human epidermal growth factor‐2 (Her‐2), and histological grade were identified as important prognostic factors for BC patients . Considering the single anatomic staging could not properly reflect the prognostic outcome of all BC patients in the individualized treatment era, some scholars suggested that these biological characteristics of BC also should be incorporated into the current TNM staging system .…”

“…5 In addition to these clinicopathologic factors, estrogen receptor (ER), progesterone receptor (PR), the expression of human epidermal growth factor-2 (Her-2), and histological grade were identified as important prognostic factors for BC patients. [6][7][8][9] Considering the single anatomic staging could not properly reflect the prognostic outcome of all BC patients in the individualized treatment era, some scholars suggested that these biological characteristics of BC also should be incorporated into the current TNM staging system. [10][11][12][13] Recently, the opinion was adopted by the 8th edition of AJCC prognostic staging system for BC, in which ER, PR, Her-2, and histological grade were incorporated into the anatomic TNM staging to evaluate the prognosis of BC patients.…”

İnvaziv Meme Karsinomlu Olgularda İmmunhistokimyasal Olarak Human Epidermal Growth Faktör 2 (Her2) 2+/ Bağımlı Ve Her2 2+/ Bağımlı Olmayan Grupların Histopatolojik Ve Klinik Prognostik Parametreler Açısından Karşılaştırılması

“…Her2 3+ ya da 2+ amplifiye hastalara tedavi uygulanırken 2+ amplifiye olmayan ya da skor 1, 0 vakalara herceptin tedavisi uygulanmaz. Adjuvan ya da neoadjuvan tedavi kararını etkileyeceğinden İSH ile ampifikasyon net olarak belirlenmelidir (2,4,5,6). Literatürde Her2 güçlü ekspresyonu dışında 1+ ve 2+ sonuçların negatif prognostik faktör olabileceği ile ilgili çalışmalar mevcuttur (5,6,7,8).…”