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Building Up a High-throughput Screening Platform to Assess the Heterogeneity of HER2 Gene Amplification in Breast Cancers
Published on: December 5, 2017
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Decision-Making Patterns for Clinically Node-Positive, Hormone Receptor-Positive, HER2-Negative Early Breast Cancer:
Yoonwon Kook1,2, Minji Lee1,2, Seung Ho Baek1,2
1Division of Breast Surgery, Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Journal of Breast Cancer
|September 29, 2025
Summary
Treatment decisions for hormone receptor-positive, HER2-negative breast cancer with suspected lymph node involvement vary among specialists. Factors like clinician background and patient menopausal status influence choices, highlighting the need for clearer guidelines and diagnostic tools.
Area of Science:
- Oncology
- Breast Cancer Research
- Clinical Decision-Making
Background:
- Chemotherapy omission is an option for select hormone receptor (HR)-positive, human epidermal growth factor receptor 2-negative (HER2-) breast cancer patients.
- Optimal initial treatment for HR+HER2- breast cancer with suspected lymph node (LN) metastasis remains debated, with options including upfront surgery, neoadjuvant chemotherapy, or genomic testing.
Purpose of the Study:
- To assess multinational breast cancer specialists' preferences for initial treatment strategies in HR+HER2- breast cancer with suspected LN involvement.
- To identify factors influencing clinical decisions in this specific patient population.
Main Methods:
- A cross-sectional survey was administered to breast cancer specialists at two time points (November 2023 and April 2024).
- 18 case scenarios with varying patient and tumor characteristics were presented, requiring respondents to select a preferred initial treatment strategy.
- Univariate and multivariate logistic regression analyses identified demographic factors associated with treatment choices.
Main Results:
- Consensus on treatment strategy was observed for postmenopausal patients and those with small, low-grade tumors and limited nodal suspicion.
- Treatment preferences varied significantly for peri- and pre-menopausal patients, especially in intermediate-risk scenarios.
- Clinician specialty, nationality, affiliation, and experience impacted treatment choices; Asian clinicians and medical oncologists favored upfront surgery for younger patients with aggressive features.
Conclusions:
- Significant consensus and variability exist in managing HR+HER2- breast cancer with suspected LN involvement among international specialists.
- Enhanced international collaboration and clear guidelines are needed, particularly for intermediate-risk cases.
- Multigene assays can aid in personalizing treatment decisions for these patients.
