HER2-positive/ER-low breast carcinoma shows a response to neoadjuvant chemotherapy similar to that of HER2-positive/ER-negative breast carcinoma

被引:1
作者
Weisman, Paul [1 ]
Ospina-Romero, Monica [1 ]
Yu, Qiqi [3 ]
Wisinski, Kari [2 ]
Xu, Jin [1 ,4 ]
机构
[1] Univ Wisconsin, Dept Pathol & Lab Med, Sch Med & Publ Hlth, Madison, WI USA
[2] Univ Wisconsin, Dept Med, Sch Med & Publ Hlth, Madison, WI USA
[3] Johns Hopkins Sch Med, Dept Pathol, Baltimore, MD USA
[4] Univ Wisconsin, Dept Pathol & Lab Med, Sch Med & Publ Hlth, 1111 Highland Ave, Madison, WI 53705 USA
关键词
HER2; ER; Neoadjuvant; PCR; Breast carcinoma; PATHOLOGICAL COMPLETE RESPONSE; CANCER; SUBTYPES; TRASTUZUMAB; MULTICENTER; NEOALTTO; ESTROGEN; OUTCOMES; THERAPY; TRIAL;
D O I
10.1016/j.prp.2022.154087
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
Negative expression of estrogen receptor (ER) predicts response to chemotherapy in breast cancers (BCs). ER negative cancers are those with less than 1 % of nuclear staining. Tumors with 1-10 % staining are sub-classified as "low-positive" (ER-low). HER2 negative tumors with ER low staining are considered biologically and clinically equivalent to ER negative tumors. This study investigates whether ER low expression in HER2-positive (HER2+) BCs has different clinical behavior than ER negative HER2-positive tumors. We used a sample of 171 patients with HER2+ BCs to compare risk of residual cancer after neoadjuvant chemotherapy by different ER expression strength. Patients were classified into 3 groups: ER-negative (ER <1 %); ER-low (ER <10 %, any intensity or <33 % staining, weak intensity); and ER-high (ER = 10-33 %, moderate to strong intensity or >33 %, any intensity). The risk of residual cancer in patients with ER-low tumors was similar to the risk in patients with ER-negative tumors (RR = 0.76, 95 % CI: 0.30-1.93). Conversely, patients with ER-high tumors had twice the risk of residual cancer than patients with ER-negative tumors (RR = 2.20, 95 % CI: 1.46-3.31). These findings persisted after adjusting for tumor grade, clinical tumor and lymph node stage, chemotherapy regimen, and progesterone receptor status. In this cohort of patients with HER2+ BCs, ER-low tumors had a similar pathologic response to chemotherapy as ER-negative tumors suggesting similar clinical behavior. Future research should address biological explanations to these similarities between ER negative and ER low breast cancers such as HER2 enriched phenomenon.
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页数:5
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