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Purpose <p>Human epidermal growth factor receptor 2 (HER2)-negative breast cancer includes HER2-zero and HER2-low tumors. Whether their clinical features and survival are different is not fully clarified. The objective was to explore their clinicopathologic differences and survival.</p> Methods/Patients <p>Retrospective analysis of HER2-negative, stage I-III breast cancer patients from 2006 to 2016 at a single site. Clinicopathological variables, events and survival are analyzed, comparing HER2-low and HER2-zero cases.</p> Results <p>Of 535 patients, 351 (65.61%) were HER2-zero and 184 (34.39%) HER2-low (154 (83.70%) score 1 + and 30 (16.30%) score 2 +). The proportion of premenopausal women was higher in the HER2-low subgroup (50.50% vs 39.40%, <i>p</i> = 0.016). For those with HER2-zero tumors, 15.70% were estrogen receptor (ER) negative, whereas only 9.20% (<i>p</i> = 0.045) of HER2-low tumors were ER negative. In HER2-low/ER negative tumors, tumor size, histologic grade, and Ki67 levels were higher. Patients with HER2-zero/ER-negative tumors were younger, had fewer comorbidities, less nodal involvement, a higher frequency of ductal histopathology, and, again, higher histologic grade and Ki67 levels.</p> <p>There were no differences in the events. The overall survival probability at 11.50 years in the HER2-zero subgroup was 0.51 (95% confidence interval (CI 95%) 0.28–0.74) and in the HER2-low subgroup 0.67 (95% CI 0.56–0.77) (<i>p</i> = 0.52).</p> Conclusions <p>HER2-zero and HER2-low breast cancers are not distinct clinicopathologic entities. The differences detected in some variables seem to depend on ER status. No prognostic differences were observed.</p>

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Comparison of clinical characteristics and survival between HER2-zero and HER2-low in early breast cancer: a retrospective observational study

  • 期刊论文

  • 发表日期：

    2025年9月3日

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  • Violeta Núñez Álvarez,
  • Belén González Castilla,
  • Belén Fernández Rivero,
  • María Hernández Carrasco,
  • Jaime Lluch Gómez,
  • Irene Sánchez Lobón,
  • María Ángeles Ocaña de la Rosa,
  • Yulema Menguiano Romero,
  • Eduardo Perdomo Zaldívar,
  • Lourdes Rodríguez Pérez,
  • Encarnación Benítez Rodríguez,
  • José Manuel Baena Cañada

摘要

Purpose

Human epidermal growth factor receptor 2 (HER2)-negative breast cancer includes HER2-zero and HER2-low tumors. Whether their clinical features and survival are different is not fully clarified. The objective was to explore their clinicopathologic differences and survival.

Methods/Patients

Retrospective analysis of HER2-negative, stage I-III breast cancer patients from 2006 to 2016 at a single site. Clinicopathological variables, events and survival are analyzed, comparing HER2-low and HER2-zero cases.

Results

Of 535 patients, 351 (65.61%) were HER2-zero and 184 (34.39%) HER2-low (154 (83.70%) score 1 + and 30 (16.30%) score 2 +). The proportion of premenopausal women was higher in the HER2-low subgroup (50.50% vs 39.40%, p = 0.016). For those with HER2-zero tumors, 15.70% were estrogen receptor (ER) negative, whereas only 9.20% (p = 0.045) of HER2-low tumors were ER negative. In HER2-low/ER negative tumors, tumor size, histologic grade, and Ki67 levels were higher. Patients with HER2-zero/ER-negative tumors were younger, had fewer comorbidities, less nodal involvement, a higher frequency of ductal histopathology, and, again, higher histologic grade and Ki67 levels.

There were no differences in the events. The overall survival probability at 11.50 years in the HER2-zero subgroup was 0.51 (95% confidence interval (CI 95%) 0.28–0.74) and in the HER2-low subgroup 0.67 (95% CI 0.56–0.77) (p = 0.52).

Conclusions

HER2-zero and HER2-low breast cancers are not distinct clinicopathologic entities. The differences detected in some variables seem to depend on ER status. No prognostic differences were observed.