Changes in ER, PR, HER2, and Their Association With Disease Outcome in Invasive Breast Carcinoma (IBC) Patients Post-Neo Adjuvant Chemotherapy (NAC) and Surgery

Background: Estrogen-receptor (ER), progesterone-receptor (PR), and human epidermal growth factor-2 (HER2) are performed on pre-neoadjuvant chemotherapy (NAC) biopsies of invasive breast carcinoma (IBC). However, they are not done routinely on post-NAC IBC with residual tumor. Objectives: This study...

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Main Authors: Monisha C Ravishankar, Pampa Ch Toi, Biswaji Dubashi, Kadambari Dharanipragada
Format: Article
Language:English
Published: SAGE Publishing 2025-06-01
Series:Breast Cancer: Basic and Clinical Research
Online Access:https://doi.org/10.1177/11782234251342463
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author Monisha C Ravishankar
Pampa Ch Toi
Biswaji Dubashi
Kadambari Dharanipragada
author_facet Monisha C Ravishankar
Pampa Ch Toi
Biswaji Dubashi
Kadambari Dharanipragada
author_sort Monisha C Ravishankar
collection DOAJ
description Background: Estrogen-receptor (ER), progesterone-receptor (PR), and human epidermal growth factor-2 (HER2) are performed on pre-neoadjuvant chemotherapy (NAC) biopsies of invasive breast carcinoma (IBC). However, they are not done routinely on post-NAC IBC with residual tumor. Objectives: This study helps in understanding the effect of alteration in expression of ER, PR, and HER2 in pre and post NAC IBC with residual tumors in terms of disease outcome, such as disease-free survival (DFS) and overall survival (OS). Design: This was a Cohort study (Prospective and Retrospective Cohort). Methods: All newly diagnosed cases of IBC who had undergone surgery after NAC with pre-NAC biopsies available with residual tumors in the breast, from January 2017 to January 2020 were enrolled in the study (n = 174) and were followed up till July 2022. Results: There were 174 cases included in this study. Of the 174 cases, 77 (44%) ER+ cases turned −ve, 10 ER +ve cases remained +ve and 87(50%) cases which were ER−ve remained the same. 48(27%) of PR +ve cases turned −ve, 10 PR +ve cases remained +ve and 116 (67%) cases remained −ve. 64(36%) of HER2 +ve cases turned −ve, 4 (2%) of HER2 +ve cases remained +ve; whereas 103(59%) cases remained −ve. The cases with changes in ER and HER2 status from positive to negative showed a longer DFS and OS which was statistically significant. Conclusion: There is a change in the HR and HER2 status in cases of IBC with residual tumor post NAC and patients with changes in the receptor status post-NAC have a better OS and DFS than those whose receptor status do not show a change.
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spelling doaj-art-d3f122e7bec04b9480c809254b4e9ce42025-08-20T02:03:24ZengSAGE PublishingBreast Cancer: Basic and Clinical Research1178-22342025-06-011910.1177/11782234251342463Changes in ER, PR, HER2, and Their Association With Disease Outcome in Invasive Breast Carcinoma (IBC) Patients Post-Neo Adjuvant Chemotherapy (NAC) and SurgeryMonisha C Ravishankar0Pampa Ch Toi1Biswaji Dubashi2Kadambari Dharanipragada3Department of Pathology, JIPMER, Puducherry, IndiaDepartment of Pathology, JIPMER, Puducherry, IndiaDepartment of Medical Oncology, JIPMER, Puducherry, IndiaDepartment of Surgery, JIPMER, Puducherry, IndiaBackground: Estrogen-receptor (ER), progesterone-receptor (PR), and human epidermal growth factor-2 (HER2) are performed on pre-neoadjuvant chemotherapy (NAC) biopsies of invasive breast carcinoma (IBC). However, they are not done routinely on post-NAC IBC with residual tumor. Objectives: This study helps in understanding the effect of alteration in expression of ER, PR, and HER2 in pre and post NAC IBC with residual tumors in terms of disease outcome, such as disease-free survival (DFS) and overall survival (OS). Design: This was a Cohort study (Prospective and Retrospective Cohort). Methods: All newly diagnosed cases of IBC who had undergone surgery after NAC with pre-NAC biopsies available with residual tumors in the breast, from January 2017 to January 2020 were enrolled in the study (n = 174) and were followed up till July 2022. Results: There were 174 cases included in this study. Of the 174 cases, 77 (44%) ER+ cases turned −ve, 10 ER +ve cases remained +ve and 87(50%) cases which were ER−ve remained the same. 48(27%) of PR +ve cases turned −ve, 10 PR +ve cases remained +ve and 116 (67%) cases remained −ve. 64(36%) of HER2 +ve cases turned −ve, 4 (2%) of HER2 +ve cases remained +ve; whereas 103(59%) cases remained −ve. The cases with changes in ER and HER2 status from positive to negative showed a longer DFS and OS which was statistically significant. Conclusion: There is a change in the HR and HER2 status in cases of IBC with residual tumor post NAC and patients with changes in the receptor status post-NAC have a better OS and DFS than those whose receptor status do not show a change.https://doi.org/10.1177/11782234251342463
spellingShingle Monisha C Ravishankar
Pampa Ch Toi
Biswaji Dubashi
Kadambari Dharanipragada
Changes in ER, PR, HER2, and Their Association With Disease Outcome in Invasive Breast Carcinoma (IBC) Patients Post-Neo Adjuvant Chemotherapy (NAC) and Surgery
Breast Cancer: Basic and Clinical Research
title Changes in ER, PR, HER2, and Their Association With Disease Outcome in Invasive Breast Carcinoma (IBC) Patients Post-Neo Adjuvant Chemotherapy (NAC) and Surgery
title_full Changes in ER, PR, HER2, and Their Association With Disease Outcome in Invasive Breast Carcinoma (IBC) Patients Post-Neo Adjuvant Chemotherapy (NAC) and Surgery
title_fullStr Changes in ER, PR, HER2, and Their Association With Disease Outcome in Invasive Breast Carcinoma (IBC) Patients Post-Neo Adjuvant Chemotherapy (NAC) and Surgery
title_full_unstemmed Changes in ER, PR, HER2, and Their Association With Disease Outcome in Invasive Breast Carcinoma (IBC) Patients Post-Neo Adjuvant Chemotherapy (NAC) and Surgery
title_short Changes in ER, PR, HER2, and Their Association With Disease Outcome in Invasive Breast Carcinoma (IBC) Patients Post-Neo Adjuvant Chemotherapy (NAC) and Surgery
title_sort changes in er pr her2 and their association with disease outcome in invasive breast carcinoma ibc patients post neo adjuvant chemotherapy nac and surgery
url https://doi.org/10.1177/11782234251342463
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