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Élise Deluche¹, Anne Vincent-Salomon²

¹Département d'oncologie médicale, CHU de Limoges, 2 avenue Martin-Luther-King, 87000 Limoges, France.

Bulletin Du Cancer

|December 31, 2021

Summary

New breast cancer classification identifies HER2-low tumors, common in over half of cases. This allows clinicians to offer novel therapies to patients with low human epidermal growth factor receptor 2 (HER2) expression.

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Area of Science:

Oncology
Pathology
Genetics

Background:

Human epidermal growth factor receptor 2 (HER2) amplification is a negative prognostic factor in breast cancer.
Current classification categorizes breast cancers as HER2-positive or HER2-negative.
Emerging therapies targeting low HER2 expression show significant promise.

Purpose of the Study:

To introduce a refined classification system for breast tumors based on HER2 expression levels.
To identify HER2-low tumors that may benefit from novel therapeutic strategies.
To inform clinicians about the potential of targeting low HER2 expression.

Main Methods:

Utilizing existing immunohistochemistry techniques calibrated to ASCO/CAP and GEFPICS recommendations.
Classifying tumors into HER2-negative (score 0), HER2-positive (score 3+ and 2+ amplified), and HER2-low (scores 1+ and 2+ not-amplified) categories.

Keywords:

Breast cancer Cancer du sein Epidemiology HER2-faible HER2-low Épidémiologie

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No changes to current pathology laboratory techniques are required.

Main Results:

HER2-low tumors are prevalent, accounting for over half of all breast cancer cases.
The proposed classification refines tumor categorization beyond binary HER2-positive/negative.
Pathology labs can identify these tumors using established methods.

Conclusions:

The identification of HER2-low breast tumors is crucial for personalized treatment strategies.
While GEFPICS does not currently mandate this classification, it facilitates clinical decision-making.
This refined classification enables clinicians to offer new treatment options to a broader patient population.