Clinical characteristics, metastasis patterns, and treatment outcomes of HER2-low breast cancer
Abstract Breast cancer (BC) is a heterogeneous disease, traditionally classified by hormone receptor and HER2 (human epidermal growth factor receptor 2) status. HER2-low, characterized by low HER2 expression without gene amplification, recently gained attention. While new therapies are promising, it...
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Nature Portfolio
2025-02-01
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| Online Access: | https://doi.org/10.1038/s41598-025-88394-6 |
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| author | Maria Elena Lacruz Saskia Thies Andrea Schmidt-Pokrzywniak Ian Wittenberg Tobias Engler Fabian Reinwald Monika Klinkhammer-Schalke Sylke Ruth Zeissig Bianca Franke Kerstin Weitmann Atanas Ignatov |
| author_facet | Maria Elena Lacruz Saskia Thies Andrea Schmidt-Pokrzywniak Ian Wittenberg Tobias Engler Fabian Reinwald Monika Klinkhammer-Schalke Sylke Ruth Zeissig Bianca Franke Kerstin Weitmann Atanas Ignatov |
| author_sort | Maria Elena Lacruz |
| collection | DOAJ |
| description | Abstract Breast cancer (BC) is a heterogeneous disease, traditionally classified by hormone receptor and HER2 (human epidermal growth factor receptor 2) status. HER2-low, characterized by low HER2 expression without gene amplification, recently gained attention. While new therapies are promising, its clinical significance remains unclear. We analysed 241,510 BC patients diagnosed between 2000 and 2020 in Germany using data from the German Cancer Registry Group. HER2 status was determined using immunohistochemistry and fluorescence in situ hybridization results, and patients were classified as HER2-positive, HER2-low or HER2-zero. Clinical features, chemosensitivity and long-term outcomes - metastasis-free survival (MFS), recurrence-free survival (RFS), and overall survival (OS) - were analysed using Cox models. HER2-low comprised 42% of female and 47% of male patients, predominantly hormone receptor positive. Metastatic patterns in HER2-low and HER2-zero were similar but differed from HER2-positive, which showed more liver metastasis and multiple metastatic sites. HER2-positive showed worse MFS, RFS, and OS than HER2-zero and HER2-low subtypes. Pathological complete response (pCR) rates after neoadjuvant chemotherapy were highest in HER2-positive. HER2-low has higher hormone receptor positivity, distinguishing it from HER2-zero. While metastatic behaviour, treatment and long-term response in HER2-low were comparable to HER2-zero, the hormone receptor status seems to play a critical role in these outcomes. |
| format | Article |
| id | doaj-art-30568ebeee0640ff95be0bc117979dcd |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj-art-30568ebeee0640ff95be0bc117979dcd2025-02-09T12:37:04ZengNature PortfolioScientific Reports2045-23222025-02-0115111110.1038/s41598-025-88394-6Clinical characteristics, metastasis patterns, and treatment outcomes of HER2-low breast cancerMaria Elena Lacruz0Saskia Thies1Andrea Schmidt-Pokrzywniak2Ian Wittenberg3Tobias Engler4Fabian Reinwald5Monika Klinkhammer-Schalke6Sylke Ruth Zeissig7Bianca Franke8Kerstin Weitmann9Atanas Ignatov10Clinical Cancer Registry Saxony-AnhaltClinical Cancer Registry Saxony-AnhaltClinical Cancer Registry Saxony-AnhaltClinical Cancer Registry Saxony-AnhaltDepartment of Obstetrics and Gynecology, University Hospital TuebingenCancer Registry of Rhineland-Palatinate in the Institute for Digital Health DataNetwork for Care, Quality and Research in Oncology (ADT), German Cancer Registry Group of the Society of German Tumour CentersNetwork for Care, Quality and Research in Oncology (ADT), German Cancer Registry Group of the Society of German Tumour CentersNetwork for Care, Quality and Research in Oncology (ADT), German Cancer Registry Group of the Society of German Tumour CentersCancer Registry Mecklenburg-Western PomeraniaDepartment of Gynecology and Obstetrics, Otto-von-Guericke UniversityAbstract Breast cancer (BC) is a heterogeneous disease, traditionally classified by hormone receptor and HER2 (human epidermal growth factor receptor 2) status. HER2-low, characterized by low HER2 expression without gene amplification, recently gained attention. While new therapies are promising, its clinical significance remains unclear. We analysed 241,510 BC patients diagnosed between 2000 and 2020 in Germany using data from the German Cancer Registry Group. HER2 status was determined using immunohistochemistry and fluorescence in situ hybridization results, and patients were classified as HER2-positive, HER2-low or HER2-zero. Clinical features, chemosensitivity and long-term outcomes - metastasis-free survival (MFS), recurrence-free survival (RFS), and overall survival (OS) - were analysed using Cox models. HER2-low comprised 42% of female and 47% of male patients, predominantly hormone receptor positive. Metastatic patterns in HER2-low and HER2-zero were similar but differed from HER2-positive, which showed more liver metastasis and multiple metastatic sites. HER2-positive showed worse MFS, RFS, and OS than HER2-zero and HER2-low subtypes. Pathological complete response (pCR) rates after neoadjuvant chemotherapy were highest in HER2-positive. HER2-low has higher hormone receptor positivity, distinguishing it from HER2-zero. While metastatic behaviour, treatment and long-term response in HER2-low were comparable to HER2-zero, the hormone receptor status seems to play a critical role in these outcomes.https://doi.org/10.1038/s41598-025-88394-6Breast cancerHER2 (human epidermal growth factor receptor 2) statusMetastasisMetastasis-free survival (MFS)Recurrence-free survival (RFS)Overall survival (OS) |
| spellingShingle | Maria Elena Lacruz Saskia Thies Andrea Schmidt-Pokrzywniak Ian Wittenberg Tobias Engler Fabian Reinwald Monika Klinkhammer-Schalke Sylke Ruth Zeissig Bianca Franke Kerstin Weitmann Atanas Ignatov Clinical characteristics, metastasis patterns, and treatment outcomes of HER2-low breast cancer Scientific Reports Breast cancer HER2 (human epidermal growth factor receptor 2) status Metastasis Metastasis-free survival (MFS) Recurrence-free survival (RFS) Overall survival (OS) |
| title | Clinical characteristics, metastasis patterns, and treatment outcomes of HER2-low breast cancer |
| title_full | Clinical characteristics, metastasis patterns, and treatment outcomes of HER2-low breast cancer |
| title_fullStr | Clinical characteristics, metastasis patterns, and treatment outcomes of HER2-low breast cancer |
| title_full_unstemmed | Clinical characteristics, metastasis patterns, and treatment outcomes of HER2-low breast cancer |
| title_short | Clinical characteristics, metastasis patterns, and treatment outcomes of HER2-low breast cancer |
| title_sort | clinical characteristics metastasis patterns and treatment outcomes of her2 low breast cancer |
| topic | Breast cancer HER2 (human epidermal growth factor receptor 2) status Metastasis Metastasis-free survival (MFS) Recurrence-free survival (RFS) Overall survival (OS) |
| url | https://doi.org/10.1038/s41598-025-88394-6 |
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