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HER2 testing is performed on breast biopsy of breast cancer patients to assess prognosis and to determine suitability for trastuzumab therapy. It is important that trastuzumab is restricted to HER2-positive individuals as it is expensive and has been associated with cardiac toxicity. [41]
HER2-low has some HER2 proteins on the cell surface, but not enough to be classified as HER2-positive. [4] Trastuzumab deruxtecan is the first approved therapy by the US Food and Drug Administration (FDA) targeted to people with the HER2-low breast cancer subtype. [4] DNA-based classification.
In early-stage HER2-positive breast cancer, trastuzumab-containing regimens improved overall survival (Hazard ratio (HR) = 0.66) and disease-free survival (HR = 0.60). [39] Increased risk of heart failure (RR = 5.11) and decline in left ventricular ejection fraction ( relative risk RR = 1.83) were seen in these trials as well. [ 39 ]
When a tumor is “triple positive,” that means that its growth is fueled by both estrogen and progesterone hormones, as well as a protein called human epidermal growth factor receptor 2 (HER2).
Triple negative breast cancer, in particular, has a worse prognosis and can be difficult to treat. There are few targeted therapies like there are for estrogen positive breast cancers, she says.
Staging breast cancer is the initial step to help physicians determine the most appropriate course of treatment. As of 2016, guidelines incorporated biologic factors, such as tumor grade, cellular proliferation rate, estrogen and progesterone receptor expression, human epidermal growth factor 2 (HER2) expression, and gene expression profiling into the staging system.
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