Is HER2-Low Breast Cancer a Distinct Prognostic Entity? Real-World Survival Outcomes from a Cohort in Colombia
- 1Epidemiology Department, Hospital Internacional de Colombia (HIC), Fundación Cardiovascular de Colombia (FCV), Fundación Universitaria FCV, Bucaramanga 680001, Colombia
- 2Oncology Department, Hospital Internacional de Colombia (HIC), Fundación Cardiovascular de Colombia (FCV), Fundación Universitaria FCV, Bucaramanga 680001, Colombia
Abstract
Background/Objectives: The HER2-low classification has redefined therapeutic strategies, but its prognostic significance remains uncertain. We compared overall survival (OS) and progression-free survival (PFS) across HER2 categories (HER2-low, HER2-negative, HER2-positive) in a real-world cohort. Methods: This was a single-center retrospective cohort study conducted at a high-complexity cancer center in Colombia; it included 373 patients with invasive breast cancer classified as HER2-positive (IHC 3+ or ISH+), HER2-low (IHC 1+ or 2+/ISH−), or HER2-negative (IHC 0). Survival was estimated by Kaplan–Meier. Multivariable Cox models were adjusted for age, clinical stage, histological grade, and hormone receptor status, and PFS was additionally analyzed separately in stage I–III and stage IV disease. Results: The cohort included HER2-low (38.3%), HER2-negative (39.7%), and HER2-positive (22.0%) tumors. HER2-low tumors showed lower grade and higher hormone receptor expression (p < 0.001), without better survival. Three-year OS (81.8%, 76.5%, 62.8%; p = 0.178) and PFS (p = 0.227) did not differ. Advanced stage remained the main determinant of mortality, whereas the association with high grade was attenuated. HER2-low was not independently associated with OS (HR 0.67; 95% CI 0.31–1.45) or PFS (HR 0.77; 95% CI 0.40–1.49). Hormone receptor positivity was associated with lower mortality (HR 0.43; 95% CI 0.21–0.88). PFS did not differ across HER2 categories in stage I–III (p = 0.307) or stage IV disease (p = 0.068). Conclusions: HER2-low status was not independently associated with survival. Its more favorable clinicopathological profile was largely explained by higher hormone receptor expression, which was itself associated with survival once included in the models.
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BibTeX
@article{manriquehernandez2026her2low,
title = {{Is HER2-Low Breast Cancer a Distinct Prognostic Entity? Real-World Survival Outcomes from a Cohort in Colombia}},
author = {Edgar Fabián Manrique-Hernández and Maricel Licht-Ardila and Johan Danilo Torres Rosas and Jorge Andrés Rincón Pallares and Michael Steven Villabona Díaz and Lady Katerine Aldana Galvis and Kendrys Hoyos and Alexandra Hurtado-Ortiz and Carlos Calderón Cortés and Diego Gómez-Abreo},
journal = {Cancers},
year = {2026},
month = oct,
doi = {10.3390/cancers18203322},
url = {https://www.mdpi.com/2072-6694/18/20/3322},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Is HER2-Low Breast Cancer a Distinct Prognostic Entity? Real-World Survival Outcomes from a Cohort in Colombia
AU - Edgar Fabián Manrique-Hernández
AU - Maricel Licht-Ardila
AU - Johan Danilo Torres Rosas
AU - Jorge Andrés Rincón Pallares
AU - Michael Steven Villabona Díaz
AU - Lady Katerine Aldana Galvis
AU - Kendrys Hoyos
AU - Alexandra Hurtado-Ortiz
AU - Carlos Calderón Cortés
AU - Diego Gómez-Abreo
PY - 2026
DA - 2026/10/01
JO - Cancers
DO - 10.3390/cancers18203322
UR - https://www.mdpi.com/2072-6694/18/20/3322
AB - Background/Objectives: The HER2-low classification has redefined therapeutic strategies, but its prognostic significance remains uncertain. We compared overall survival (OS) and progression-free survival (PFS) across HER2 categories (HER2-low, HER2-negative, HER2-positive) in a real-world cohort. Methods: This was a single-center retrospective cohort study conducted at a high-complexity cancer center in Colombia; it included 373 patients with invasive breast cancer classified as HER2-positive (IHC 3+ or ISH+), HER2-low (IHC 1+ or 2+/ISH−), or HER2-negative (IHC 0). Survival was estimated by Kaplan–Meier. Multivariable Cox models were adjusted for age, clinical stage, histological grade, and hormone receptor status, and PFS was additionally analyzed separately in stage I–III and stage IV disease. Results: The cohort included HER2-low (38.3%), HER2-negative (39.7%), and HER2-positive (22.0%) tumors. HER2-low tumors showed lower grade and higher hormone receptor expression (p < 0.001), without better survival. Three-year OS (81.8%, 76.5%, 62.8%; p = 0.178) and PFS (p = 0.227) did not differ. Advanced stage remained the main determinant of mortality, whereas the association with high grade was attenuated. HER2-low was not independently associated with OS (HR 0.67; 95% CI 0.31–1.45) or PFS (HR 0.77; 95% CI 0.40–1.49). Hormone receptor positivity was associated with lower mortality (HR 0.43; 95% CI 0.21–0.88). PFS did not differ across HER2 categories in stage I–III (p = 0.307) or stage IV disease (p = 0.068). Conclusions: HER2-low status was not independently associated with survival. Its more favorable clinicopathological profile was largely explained by higher hormone receptor expression, which was itself associated with survival once included in the models.
SN - 2072-6694
ER -