A Comparative Analysis of the Value of HER2 Immunohistochemistry Scoring in Primary and Metastatic Breast Cancer, in the Era of HER2 "Low" Breast Cancers.

IF 2.9 3区医学 Q2 ONCOLOGY

Clinical breast cancer Pub Date : 2024-12-04 DOI:10.1016/j.clbc.2024.11.017

Swati Bhardwaj, Shabnam Jaffer

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引用次数: 0

Abstract

Background: In the DESTINY-B04 trial, patients with pretreated HER2 low metastatic breast cancer (defined as immunohistochemistry score of 1+ or 2+ and negative in situ hybridization) had significant survival improvement with Trastuzumab therapy.

Methods: The goal of our study was to compare the HER2 immunohistochemistry scores of paired primary and metastatic breast cancer, with emphasis on HER2 low criteria and its implications for detailed immunohistochemistry interpretation. Using the pathology database from 2011, we identified 272 cases of primary breast cancers with paired metastases. We reviewed and performed immunohistochemistry concordance between the primary and metastases and calculated the HER2 low incidence.

Results: Compared to the primary, HER2 immunohistochemistry score in the metastases remained the same in 156/272 cases (57%) and by immunohistochemistry was: 0 (67/114 = 59%), 1+ (22/52 = 42%), 2+ (34/67 = 51%), 3+ (33/39 = 85%) and HER2 low (85/119 = 71%). The HER2 score changed from 0 to HER2 low in 46 cases (17%) and vice versa in 30 (11%).

Conclusions: The concordance rate of HER2 immunohistochemistry scores was 57%, highest in 3+ cases, followed by HER2 low and then HER2 negative. The incidence of HER2 low was higher in the metastases by 6% compared to the primary. HER2 should be tested in all metastases and compared with the primary, due to differences in scores as seen in 28% of our cases, which may have clinical implications in the new HER2 low era.

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在HER2“低”乳腺癌时代，HER2免疫组化评分在原发性和转移性乳腺癌中的价值比较分析

背景：在DESTINY-B04试验中，经预处理的HER2低转移性乳腺癌（定义为免疫组织化学评分为1+或2+，原位杂交阴性）患者接受曲妥珠单抗治疗后生存率显著提高。方法：本研究的目的是比较配对原发性和转移性乳腺癌的HER2免疫组织化学评分，重点是HER2低标准及其对详细免疫组织化学解释的意义。利用2011年的病理数据库，我们确定了272例伴有配对转移的原发性乳腺癌。我们回顾并进行了原发和转移瘤之间的免疫组织化学一致性，并计算了HER2低发生率。结果：与原发灶相比，156/272例（57%）转移灶的HER2免疫组化评分保持不变，分别为0（67/114 = 59%）、1+(22/52 = 42%)、2+(34/67 = 51%)、3+(33/39 = 85%)和HER2低（85/119 = 71%）。HER2评分由0变为低的有46例（17%），反之有30例（11%）。结论：HER2免疫组化评分的符合率为57%，以3+例最高，其次为HER2低，最后为HER2阴性。HER2低的发生率在转移灶中比原发灶高6%。应该在所有转移瘤中检测HER2，并将其与原发瘤进行比较，因为28%的病例在评分上存在差异，这可能在新的HER2低水平时代具有临床意义。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical breast cancer 医学-肿瘤学

CiteScore

5.40

自引率

3.20%

发文量

174

审稿时长

48 days

期刊介绍： Clinical Breast Cancer is a peer-reviewed bimonthly journal that publishes original articles describing various aspects of clinical and translational research of breast cancer. Clinical Breast Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of breast cancer. The main emphasis is on recent scientific developments in all areas related to breast cancer. Specific areas of interest include clinical research reports from various therapeutic modalities, cancer genetics, drug sensitivity and resistance, novel imaging, tumor genomics, biomarkers, and chemoprevention strategies.