TNBC is noted for its aggressive behavior and poor prognosis. Recently developed HER2 target agents have shown potential benefit even in HER2-low expressing breast cancers. This study retrospectively analyzed 2542 non-metastatic TNBC patients from 2008 to 2020, revealing that 26.0% were HER2-low. Data on demographics, tumor characteristics, pathologic complete response (pCR) rates and disease-free survival (DFS), distant metastasis-free survival (DMFS), overall survival (OS), and breast cancer-specific survival (BCSS) were analyzed. The HER2-low group, compared to the HER2-0 group, showed significantly better DFS, DMFS, OS, BCSS (p= 0.0072,p= 0.0096,p= 0.0180, andp= 0.0001, respectively) with older age and higher rates of postmenopausal status (p< 0.0001). No significant differences in pCR rates were observed. Multivariate analyses identified HER2 status as a significant prognostic factor for DFS (p= 0.048), DMFS (p= 0.018), OS (p= 0.049), and BCSS (p= 0.008). Subgroup analysis revealed that these effects varied with menopausal status, showing more pronounced benefits in postmenopausal women. Our findings suggest that HER2-low TNBC patients exhibit a distinct clinical profile and improved survival compared to HER2-0 TNBC patients, especially in postmenopausal patients. Further research on estrogen and HER2 interaction is needed.
三阴性乳腺癌（TNBC）以其侵袭性强和预后不良而著称。近期研发的HER2靶向药物即使在HER2低表达的乳腺癌中也显示出潜在获益。本研究回顾性分析了2008年至2020年间的2542例非转移性TNBC患者，发现其中26.0%为HER2低表达。研究分析了人口统计学特征、肿瘤特征、病理完全缓解（pCR）率以及无病生存期（DFS）、无远处转移生存期（DMFS）、总生存期（OS）和乳腺癌特异性生存期（BCSS）等数据。与HER2-0组相比，HER2低表达组在DFS、DMFS、OS和BCSS方面均表现出显著更优（p值分别为0.0072、0.0096、0.0180和0.0001），且患者年龄更大、绝经后比例更高（p<0.0001）。两组间pCR率未见显著差异。多变量分析显示，HER2状态是DFS（p=0.048）、DMFS（p=0.018）、OS（p=0.049）和BCSS（p=0.008）的显著预后因素。亚组分析表明，这些效应随绝经状态而异，在绝经后女性中获益更为明显。我们的研究结果表明，与HER2-0 TNBC患者相比，HER2低表达TNBC患者具有独特的临床特征和更好的生存预后，尤其在绝经后患者中更为显著。未来需要进一步研究雌激素与HER2之间的相互作用。
The Prognostic Impact of HER2-Low and Menopausal Status in Triple-Negative Breast Cancer
肿瘤(癌症)患者之家