Prognostic difference between early breast cancer patients with HER2 low and HER2 zero status

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Abstract

We aimed to investigate the differences in prognosis between patients with HER2-low and HER2-zero status. This retrospective cohort study conducted at multi-institution included 1627 patients diagnosed with HER2-low or HER2-zero breast cancer (stages I–III). Survival analysis after propensity score matching was used. In total, 445 patients with HER2-low and 707 patients with HER2-zero status were included. The median follow-up was 92.7 months. Locoregional and distant recurrence-free survival were comparable between patients with HER2-low and HER2-zero status (p = 0.872, p = 0.746, respectively). HER2-low status did not affect overall survival. However, in subgroups with lymph node metastases, patients with HER2-low status showed better recurrence-free survival compared with that of patients with HER2-zero status (p = 0.033). In conclusion, survival outcomes were comparable between patients with HER2-low and HER2-zero breast cancer. More studies are needed to validate our findings and examine the biological mechanism underlying these prognostic differences.

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Cha, C. D., Kim, K. E., Kim, J., Um, E., Choi, N., Lee, J., … Chung, M. S. (2025). Prognostic difference between early breast cancer patients with HER2 low and HER2 zero status. Npj Breast Cancer, 11(1). https://doi.org/10.1038/s41523-025-00737-8

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