HER2 and hormone receptor conversion after neoadjuvant therapy for breast cancer

BackgroundThe expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) in residual lesions may be different compared with primary tumors of the breast after neoadjuvant therapy (NAT). Given the clinical implications of hormone receptor exp...

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Main Authors: Jing Wang, Xin Long, Mingxi Tang, Xiuli Xiao
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1522460/full
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author Jing Wang
Jing Wang
Xin Long
Xin Long
Mingxi Tang
Xiuli Xiao
author_facet Jing Wang
Jing Wang
Xin Long
Xin Long
Mingxi Tang
Xiuli Xiao
author_sort Jing Wang
collection DOAJ
description BackgroundThe expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) in residual lesions may be different compared with primary tumors of the breast after neoadjuvant therapy (NAT). Given the clinical implications of hormone receptor expression for breast cancer management, we assessed conversions in ER, PR, and HER2 in breast cancer patients after NAT.MethodsOur study comprised 589 individuals with aggressive breast cancer who underwent NAT. We examined the ER, PR, and HER2 statuses in primary and residual breast cancers and investigated the relationship between receptor conversion and clinicopathological variables.ResultsThe pathologic complete response (pCR) rate for the overall cohort was 38.7%, with pCR rates of 57.0%, 13.1%, and 33.3% for HER2-positive, Luminal, and triple-negative breast cancer (TNBC), respectively. Cases with negative hormone receptor expression were more likely to achieve pCR than positive cases. The highest pCR rates were seen in HER2-positive breast cancers, followed by HER2-zero and HER2-low tumors. After NAT, there were 26 (7.8%) cases of ER status conversion and 53 (16.0%) cases of PR status conversion. The conversion of hormone receptors was mainly from positive to negative. When cases were categorized as HER2-negative or positive, 15 (5.1%) cases had a conversion of HER2 status, predominantly positive to negative. When cases were classified as HER2-zero, -low, or -positive, HER2 status conversion happened in 54 (18.6%) cases and was mostly happened between HER2-zero and HER2-low. HER2 status before NAT correlated with ER and HER2 conversion.ConclusionSome breast cancer patients may show ER, PR, or HER2 status conversion after NAT. Residual lesions need to be immunohistochemically re-tested to reassess the patient’s receptor expression status and to adjust the subsequent treatment regimen.
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spelling doaj-art-4c9d71b27336429b8a612f6c7c3a6d122025-08-20T02:05:20ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-06-011510.3389/fonc.2025.15224601522460HER2 and hormone receptor conversion after neoadjuvant therapy for breast cancerJing Wang0Jing Wang1Xin Long2Xin Long3Mingxi Tang4Xiuli Xiao5Department of Pathology, Yaan People’s Hospital, Yaan, Sichuan, ChinaDepartment of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, ChinaSchool of Basic Medical Sciences, Southwest Medical University, Luzhou, Sichuan, ChinaSchool of Clinical Medical Sciences, Southwest Medical University, Luzhou, Sichuan, ChinaDepartment of Pathology, Yaan People’s Hospital, Yaan, Sichuan, ChinaDepartment of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, ChinaBackgroundThe expression of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) in residual lesions may be different compared with primary tumors of the breast after neoadjuvant therapy (NAT). Given the clinical implications of hormone receptor expression for breast cancer management, we assessed conversions in ER, PR, and HER2 in breast cancer patients after NAT.MethodsOur study comprised 589 individuals with aggressive breast cancer who underwent NAT. We examined the ER, PR, and HER2 statuses in primary and residual breast cancers and investigated the relationship between receptor conversion and clinicopathological variables.ResultsThe pathologic complete response (pCR) rate for the overall cohort was 38.7%, with pCR rates of 57.0%, 13.1%, and 33.3% for HER2-positive, Luminal, and triple-negative breast cancer (TNBC), respectively. Cases with negative hormone receptor expression were more likely to achieve pCR than positive cases. The highest pCR rates were seen in HER2-positive breast cancers, followed by HER2-zero and HER2-low tumors. After NAT, there were 26 (7.8%) cases of ER status conversion and 53 (16.0%) cases of PR status conversion. The conversion of hormone receptors was mainly from positive to negative. When cases were categorized as HER2-negative or positive, 15 (5.1%) cases had a conversion of HER2 status, predominantly positive to negative. When cases were classified as HER2-zero, -low, or -positive, HER2 status conversion happened in 54 (18.6%) cases and was mostly happened between HER2-zero and HER2-low. HER2 status before NAT correlated with ER and HER2 conversion.ConclusionSome breast cancer patients may show ER, PR, or HER2 status conversion after NAT. Residual lesions need to be immunohistochemically re-tested to reassess the patient’s receptor expression status and to adjust the subsequent treatment regimen.https://www.frontiersin.org/articles/10.3389/fonc.2025.1522460/fullbreast cancerneoadjuvant therapyestrogen receptorprogesterone receptorhuman epidermal growth factor receptor 2
spellingShingle Jing Wang
Jing Wang
Xin Long
Xin Long
Mingxi Tang
Xiuli Xiao
HER2 and hormone receptor conversion after neoadjuvant therapy for breast cancer
Frontiers in Oncology
breast cancer
neoadjuvant therapy
estrogen receptor
progesterone receptor
human epidermal growth factor receptor 2
title HER2 and hormone receptor conversion after neoadjuvant therapy for breast cancer
title_full HER2 and hormone receptor conversion after neoadjuvant therapy for breast cancer
title_fullStr HER2 and hormone receptor conversion after neoadjuvant therapy for breast cancer
title_full_unstemmed HER2 and hormone receptor conversion after neoadjuvant therapy for breast cancer
title_short HER2 and hormone receptor conversion after neoadjuvant therapy for breast cancer
title_sort her2 and hormone receptor conversion after neoadjuvant therapy for breast cancer
topic breast cancer
neoadjuvant therapy
estrogen receptor
progesterone receptor
human epidermal growth factor receptor 2
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1522460/full
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