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<p>Human epidermal growth factor receptor 2 (HER2) is a crucial prognostic biomarker for breast cancer patients receiving neoadjuvant treatment. There is a difference between HER2/neu (3+) and HER2/neu (2+)/dual in situ hybridization(DISH)-positive tumors in their responses to anti-HER2 treatment. To compare therapeutic responses in post-neoadjuvant chemotherapy (NAC) breast cancer cases with preoperative HER2/neu (2+)/DISH-positive versus HER2/neu (3+) expression, evaluate clinicopathological factors influencing variations in therapeutic response, and clarify how different HER2 expression levels correlate with NAC outcomes. This retrospective study included 65 NAC-treated patients diagnosed with invasive breast cancer who underwent excisional surgery. Samples were immunohistochemically analyzed for estrogen receptor, progesterone receptor, HER2/neu, and Ki-67 proliferation index, and correlated with post-NAC response. Pathologic complete response (pCR) was significantly influenced by tumor site, side, focality, histological type and grade, presence of in situ, lymphovascular emboli, clinical T and N stages, and HER2 expression (p ≤ 0.05). HER2 (3+) displayed higher pCR rates (pCR: 50%, p = 0.001). About 79% of residual cancer burden (RCB)-0 and all RCB-I cases were HER2 (3+), whereas all RCB-II and 72% of RCB-III cases were HER2 (2+)/DISH-positive. Other variables (hormone receptor and Ki-67 expression, hormonal therapy, and number of neoadjuvant therapy cycles did not affect pCR (p &gt; 0.05). Compared to HER2 IHC (2 +)/DISH-positive cases, HER2 IHC (3+) breast cancer showed a significantly higher pCR rate (p ≤ 0.05), suggesting a positive correlation between the degree of HER2 protein expression and the therapeutic response to anti-HER2 treatment.</p>

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Comparative histopathological, immunohistochemical, and DISH evaluation of neoadjuvant therapy response in HER2/neu-positive breast cancer subgroups

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年4月23日

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  • Yousra Shalaby,
  • Abeer Amal,
  • Sara Abou-Fandoud

摘要

Human epidermal growth factor receptor 2 (HER2) is a crucial prognostic biomarker for breast cancer patients receiving neoadjuvant treatment. There is a difference between HER2/neu (3+) and HER2/neu (2+)/dual in situ hybridization(DISH)-positive tumors in their responses to anti-HER2 treatment. To compare therapeutic responses in post-neoadjuvant chemotherapy (NAC) breast cancer cases with preoperative HER2/neu (2+)/DISH-positive versus HER2/neu (3+) expression, evaluate clinicopathological factors influencing variations in therapeutic response, and clarify how different HER2 expression levels correlate with NAC outcomes. This retrospective study included 65 NAC-treated patients diagnosed with invasive breast cancer who underwent excisional surgery. Samples were immunohistochemically analyzed for estrogen receptor, progesterone receptor, HER2/neu, and Ki-67 proliferation index, and correlated with post-NAC response. Pathologic complete response (pCR) was significantly influenced by tumor site, side, focality, histological type and grade, presence of in situ, lymphovascular emboli, clinical T and N stages, and HER2 expression (p ≤ 0.05). HER2 (3+) displayed higher pCR rates (pCR: 50%, p = 0.001). About 79% of residual cancer burden (RCB)-0 and all RCB-I cases were HER2 (3+), whereas all RCB-II and 72% of RCB-III cases were HER2 (2+)/DISH-positive. Other variables (hormone receptor and Ki-67 expression, hormonal therapy, and number of neoadjuvant therapy cycles did not affect pCR (p > 0.05). Compared to HER2 IHC (2 +)/DISH-positive cases, HER2 IHC (3+) breast cancer showed a significantly higher pCR rate (p ≤ 0.05), suggesting a positive correlation between the degree of HER2 protein expression and the therapeutic response to anti-HER2 treatment.