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Abstract：
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, and p = 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.
摘要：
TNBC因其攻击行为和不良预后而闻名。最近开发的HER2靶向药物甚至在HER2低表达乳腺癌中也显示出潜在的益处。这项研究回顾性分析了2008年至2020年的2542例非转移性TNBC患者，发现26.0％的HER2低。人口统计数据，肿瘤特征，病理完全缓解(pCR)率和无病生存率(DFS)，无远处转移生存期（DMFS），总生存期（OS），和乳腺癌特异性生存率（BCSS）进行了分析。HER2低组，与HER2-0组相比，显示出明显更好的DFS，DMFS,操作系统,BCSS（分别为p=0.0072，p=0.0096，p=0.0180和p=0.0001）年龄较大，绝经后状态发生率较高（p<0.0001）。没有观察到pCR率的显著差异。多变量分析确定HER2状态是DFS的重要预后因素（p=0.048），DMFS（p=0.018），OS(p=0.049),和BCSS(p=0.008)。亚组分析显示，这些影响因绝经状态而异，在绝经后妇女中显示出更明显的益处。我们的研究结果表明，与HER2-0TNBC患者相比，低HER2TNBC患者表现出明显的临床特征和改善的生存率。尤其是绝经后患者。需要进一步研究雌激素和HER2的相互作用。
