浸润性乳腺癌HER2≥4.0和<6.0:21基因表达试验和mamaprint Plus BluePrint检测的风险分类和分子分型

Pub Date : 2023-01-01 DOI:10.2147/BCTT.S420738
Qianming Bai, Hong Lv, Longlong Bao, Yu Yang, Xin Zhang, Heng Chang, Tian Xue, Min Ren, Xiaoli Zhu, Xiaoyan Zhou, Wentao Yang
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引用次数: 0

摘要

目的:探讨HER2≥4.0的浸润性乳腺癌的HER2状态及临床病理特征。方法:选取40例HER2≥4.0的乳腺癌患者。两组均以浸润性癌(NOS)为主,组织学分级为ⅱ级,HR+, Ki-67≥20%,HER2 2+,复发风险高,但a组患者较年轻,淋巴结转移较多。令人惊讶的是,两组HR+乳腺癌均为光型,HR-均为基底型或未知,所有病例的HER2指数均为毫无疑问,A组乳腺癌一直被诊断为HER2扩增,更有可能是HER2阴性,并且从抗HER2新辅助化疗中获益较少。在评估HER2 FISH时,应将A组乳腺癌与经典HER2阳性乳腺癌区分开来,并将更大的A组患者纳入进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Invasive Breast Cancer with HER2 ≥4.0 and <6.0: Risk Classification and Molecular Typing by a 21-Gene Expression Assay and MammaPrint Plus BluePrint Testing.

Invasive Breast Cancer with HER2 ≥4.0 and <6.0: Risk Classification and Molecular Typing by a 21-Gene Expression Assay and MammaPrint Plus BluePrint Testing.

Invasive Breast Cancer with HER2 ≥4.0 and <6.0: Risk Classification and Molecular Typing by a 21-Gene Expression Assay and MammaPrint Plus BluePrint Testing.

Invasive Breast Cancer with HER2 ≥4.0 and <6.0: Risk Classification and Molecular Typing by a 21-Gene Expression Assay and MammaPrint Plus BluePrint Testing.

Purpose: To investigate the HER2 status and clinicopathological features in invasive breast cancer with HER2 ≥4.0 and <6.0, which has always been controversial.

Methods: Forty breast cancer cases with HER2 ≥4.0 and <6.0 by fluorescence in situ hybridization (FISH) were collected and classified into two groups based on the HRE2/CEP17 ratio (Group A: ≥2.0, n=22; Group B: <2.0, n=18). Clinicopathological characteristics, HER2 status, risk classification, and molecular typing were further analyzed and compared by 21-Gene expression assay and MammaPrint plus BluePrint test.

Results: The majority of cases in both groups were invasive carcinoma (NOS), with histological grade II, HR+, Ki-67 ≥20%, HER2 2+, and a high risk of recurrence, although younger patients and lymph node metastases were more common in Group A. Surprisingly, all HR+ breast cancers in both groups were classified as luminal-type, HR- cases were all basal-type or unknown, and the index of HER2 in all cases was <0.000 using the BluePrint test, which indicated that HER2 status should be negative. Furthermore, the level of HER2 mRNA expression in all cases of both groups was <10.7, which was defined as HER2 negative by the 21-Gene expression assay. In addition, 10 patients of Group A received anti-HER2 neoadjuvant therapy; only one patient with HR- achieved Grade 5 based on the Miller-Payne system, whereas none of the patients achieved pathological complete response (pCR) based on the Residual Cancer Burden system.

Conclusion: Group A breast cancer, which has always been unquestionably diagnosed as HER2 amplification, was more likely to be HER2 negative and derived less benefit from anti-HER2 neoadjuvant chemotherapy. Group A breast cancer should be distinguished from classical HER2-positive breast cancers when assessing HER2 FISH, and a larger cohort of Group A patients should be included in further studies.

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