ArticleClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2026
Investigation of the prevalence of HER2-ultralow and the effects of HER2 status (HER2-null vs. HER2-ultralow) on survival in HER2-negative early-stage breast cancer.
Article in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
purposeInvestigation of 'HER2-ultralow' prevalence and the effects of HER2 status (HER2-null vs. HER2-ultralow) on prognosis in patients with early-stage (non-metastatic) breast cancer. METHODS/PATIENTS: This single-center, retrospective study analyzed 424 patients with early-stage, CerbB2 immunohistochemistry (IHC) score 0 breast cancer. Pathological re-review classified tumors as HER2-ultralow (≤ 10% of tumor cells with faint, incomplete membrane staining) or HER2-null (no staining). The cohorts were stratified by estrogen receptor (ER) status into ER + (≥ 1%) and triple-negative breast cancer (TNBC) groups.
resultsThis study included 235 ER + and 189 TNBC patients. HER2-ultralow frequency was 30.6% (n = 72) in the ER + group and 18% (n = 34) in the TNBC group. In the ER + group, higher Ki67 and increasing stage were associated with worse 5 year disease-free survival (DFS) (p = 0.006 and p < 0.001, respectively), while HER2 status had no significant effect on 5-year DFS (p = 0.269). In the TNBC group, HER2-ultralow patients had worse 5-year DFS than HER2-null patients (67% vs. 74.1%, p = 0.048). In multivariate analysis, HER2 status was a statistically significant prognostic factor [(HR: 0.34 (0.145-0.841), p = 0.019)]. Despite a numerically worse 5 year overall survival (OS) rate in HER2-ultralow versus HER2-null patients (73.2% vs. 79.5%), the difference was statistically insignificant (p = 0.114).
conclusionsIn TNBC, HER2-ultralow was a poor prognostic factor associated with inferior 5 year DFS compared to HER2-null, while no difference was observed in the ER + cohort. These findings suggest that HER2-ultralow status may identify a TNBC subgroup that warrants novel therapies, such as T-DXd, although validation in larger studies is needed.
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