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Cáncer de mama HER2-bajo en la interfaz de la patología y la tecnología: hacia una gestión de precisión

Faezeh Shekari¹, Reza Bayat Mokhtari^1,2,3,4, Razieh Salahandish^5,6

¹Department of Biomedical and Molecular Sciences, Queen's University, Kingston, ON K7L 3N6, Canada.

|January 28, 2026

Resumen

La identificación precisa del cáncer de mama HER2-bajo es un desafío. Las biopsias líquidas y los diagnósticos mejorados por IA ofrecen soluciones prometedoras para la estratificación precisa de los pacientes y las estrategias de tratamiento personalizadas.

Área de la Ciencia:

Oncología
Patología
Biotecnología

Sus antecedentes:

El cáncer de mama HER2-bajo presenta una nueva categoría clínica más allá de las clasificaciones tradicionales de HER2.
Estos tumores muestran características distintas y sensibilidad a los conjugados anticuerpo-fármaco, pero la identificación precisa se ve obstaculizada por limitaciones diagnósticas.
La expresión de HER2 puede variar debido a la heterogeneidad y los cambios temporales, lo que complica el diagnóstico.

Objetivo del estudio:

Revisar los aspectos biológicos y clínicos del cáncer de mama HER2-bajo.
Evaluar tecnologías de diagnóstico innovadoras, centrándose en biopsias líquidas e IA.
Explorar avances que mejoren la precisión diagnóstica y la monitorización del cáncer de mama HER2-bajo.

Principales métodos:

Se realizó una revisión narrativa de la literatura.
Se examinaron las pruebas de HER2 basadas en tejidos, los métodos de biopsia líquida (células tumorales circulantes, ácidos nucleicos, vesículas extracelulares, HER2 soluble) y las aplicaciones de IA.
Se evaluó la IA en histopatología y sistemas de diagnóstico multimodal.

Principales resultados:

Las biopsias líquidas proporcionan una evaluación HER2 mínimamente invasiva y en tiempo real, superando potencialmente las limitaciones de los ensayos basados en tejidos.
La histopatología mejorada por IA y los sistemas multimodales mejoran la reproducibilidad y la predicción de la respuesta al tratamiento.
Los marcos emergentes de biosensores e IA para la monitorización apoyan la evaluación continua de la enfermedad.

Conclusiones:

El diagnóstico del cáncer de mama HER2-bajo está evolucionando con los avances tecnológicos.
La integración de biopsias líquidas con diagnósticos impulsados por IA puede mejorar la estratificación de precisión.
Estos enfoques integrados pueden guiar terapias personalizadas para pacientes con cáncer de mama HER2-bajo.

Palabras clave:

cáncer de mama HER2-bajo biosensores rasgos clinicopatológicos estado del receptor hormonal biopsia líquida diagnóstico de precisión

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