Authors
Zhengyang Dong, Si Wu, Jiaxian Miao, Hongbo Liu, Yueping Liu, Yan Ding
Published in
Journal of clinical pathology. Jul 06, 2026. Epub Jul 06, 2026.
Abstract
Traditional breast cancer treatment relies on binary human epidermal growth factor receptor 2 (HER2) classification, while HER2-low breast cancer represents an intermediate subgroup. Given the efficacy of novel antibody-drug conjugates, this study aimed to clarify whether HER2-low breast cancer is biologically and clinically distinct from HER2-0 disease, especially in response to neoadjuvant chemotherapy.
A retrospective analysis was performed on 1274 early breast cancer patients receiving neoadjuvant chemotherapy. Patients were divided into HER2-0 (n=210), HER2-low (n=590) and HER2-positive (n=474) groups. Clinicopathological features, pathological complete response (pCR) and long-term survival were compared.
HER2-low tumours were predominant in Luminal A-like subtype, with lower pCR rate (14.7%) than HER2-0 (27.6%) and HER2-positive (35.5%) groups. Hormone receptor (HR)-positive status was associated with higher pCR in HER2-low patients. HER2-low tumours showed higher lymph node metastasis and lower Ki-67 levels. No significant differences in disease-free survival (DFS) or overall survival (OS) were observed between HER2-low and HER2-0 groups, with distinct prognostic factors for each subgroup.
HER2-low breast cancer exhibits unique clinicopathological features and differential chemotherapy response. However, it shows similar survival to HER2-0 disease with standard neoadjuvant chemotherapy. The clinical value of HER2-low status may rely on targeted antibody-drug conjugate therapy.
PMID:
42409624
Bibliographic data and abstract were imported from PubMed on 07 Jul 2026.
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