Breast Cancer: Targets and Therapy (Mar 2024)

HER2 Low Expression in Primary Male Breast Cancer

  • Nobbe K,
  • Erices-Leclercq M,
  • Foerster F,
  • Förster R,
  • Baldus SE,
  • Rudlowski C,
  • Schröder L,
  • Lubig S

Journal volume & issue
Vol. Volume 16
pp. 141 – 148

Abstract

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Katleen Nobbe,1 Melanie Erices-Leclercq,1 Frank Foerster,2,3 Robert Förster,4 Stephan E Baldus,5 Christian Rudlowski,1,6 Lars Schröder,7 Sabine Lubig1 1Breast Unit, Lutheran Hospital Bergisch Gladbach, Bergisch Gladbach, Germany; 2Department of Economical Sciences, University of Applied Sciences, Zwickau, Germany; 3Outpatient Department of Gynaecological Oncology and Palliative Care, Chemnitz, Germany; 4Institute for Radiation Oncology, Cantonal Hospital Winterthur, Winterthur, Switzerland; 5Institute for Pathology, Cytology and Molecular Pathology, Bergisch Gladbach, Germany; 6Department of Gynecology, University Hospital Bonn, Bonn, Germany; 7Department of Gynaecology and Obstetrics, Ketteler Krankenhaus, Offenbach, GermanyCorrespondence: Christian Rudlowski, Breast Unit, Lutheran Hospital Bergisch Gladbach, Ferrenbergstrasse 24, Bergisch Gladbach, 51465, Germany, Email [email protected]: The introduction of HER2-targeting antibody drug conjugates (ADCs) offers new treatment options for female breast cancer patients (FBC) expressing low levels of HER2 (HER2 low). No evidence was found that HER2 low describes a new FBC subtype. There is a lack of studies determining the impact of HER2 low in male breast cancer (MBC). In this study, we evaluate the prevalence of HER2 low in primary MBC and correlate the results with patient characteristics.Patients and Methods: In this study, histological specimens were obtained from 120 male patients diagnosed and treated for primary invasive breast cancer from 1995 to 2022 at Breast Cancer Units in Bergisch Gladbach, Chemnitz, and Zwickau, Germany. HER2 immunostaining and in situ hybridization were performed by central pathology and evaluated based on the ASCO/CAP guidelines. The correlation of expression of HER2 low with tumor biological characteristics and patient outcomes was investigated.Results: Out of all cases, four patients (3.3%) showed HER2 positivity (3+), 39 (32.5%) patients were classified as HER2 low, 7 (5.8%) were HER2 2+ (no amplification), 32 (26.7%) were HER2 1+, and 77 (64.2%) were classified as HER2 zero. Out of 77 HER2 zero cases, 47 tumors (61.0%) showed incomplete staining, with < 10% of tumor cells classified as HER2 ultralow. No statistical correlation between HER2 low and tumor biological characteristics and patients’ survival was found.Conclusion: Our findings show a notable, albeit lower, prevalence of HER2 low expression in primary MBC. However, tumors expressing HER2 low do not show specific tumor biological features to define a new breast cancer subtype in MBC. Our results suggest that a significant number of MBC patients could benefit from ADCs, as shown in FBC. Further studies are required to better understand HER2 low breast cancer, both generally and in MBC.Keywords: male breast cancer, HER2 low, prognosis, survival

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