[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-detail-43330-en":3,"doc-seo-43330-105":30,"detail-sidebar-cat-0-en-105":91},{"code":4,"msg":5,"data":6},0,"success",{"doc_id":7,"user_id":8,"nickname":9,"user_avatar":10,"doc_module":4,"category_id":11,"category_name":12,"doc_title":13,"doc_description":14,"doc_content":15,"file_id":16,"file_url":17,"file_type":18,"file_size":19,"view_count":20,"is_deleted":4,"is_public":21,"is_downloadable":21,"audit_status":21,"page_count":22,"language":23,"language_code":24,"site_id":25,"html_lang":24,"table_of_contents":26,"faqs":27,"seo_title":13,"seo_description":14,"update_tm":28,"read_time":29},43330,2336464648746,"Skyler","https://ap-avatar.wpscdn.com/davatar_276721f389ce27ea32af1340a28f341c",8,"Research & Report","The Evolution and Prognostic Impact of HER2-Low, HER2-Ultralow, and HER2-Null Status in HER2-Negative Early Breast Cancer","Prognostic relevance of HER2-low, HER2-ultralow, and HER2-null status in HER2-negative early breast cancer, and its change during neoadjuvant chemotherapy, remains unclear. Analyzed 810 HER2-negative patients (2011–2021) with centrally confirmed pre- and post-NAC HER2 status; logistic regression assessed pCR (ypT0/is ypN0), and multivariable Cox models evaluated iDFS and overall survival. HER2 expression showed an inverse relationship with pCR and was linked to improved iDFS and OS, with notable category conversion after NAC.","DOI: 10. 1002/cncr.70269  \nORIGINAL ARTICLE  \nThe evolution and prognostic impact of HER2-low, HER2-ultralow, and HER2-null status in HER2-negative early breast cancer: A pre— to post—neoadjuvant chemotherapy study  \nYibin Qiu MD 1,2,3 | Long Wu MD4 | Weifeng Cai MD 1,2,3 | Minyan Chen MD1,2,3 | Meichen Jiang MD4 | Yali Wang MD PhD1,2,3 | Shunyi Liu MD1,2,3  |  \nPeng He MD 1,2,3 | Yuxiang Lin MD PhD1,2,3 | Lili Chen MD 1,2,3 |  \nYinghong Yang MD4 | Chuan Wang MD PhD 1,2,3  | Jie Zhang MD PhD 1,2,3  | Fangmeng Fu MD PhD1,2,3   \n1Department of Breast Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China  \n2Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, Fujian, China  \n3Breast Cancer Institute, Fujian Medical University, Fuzhou, Fujian, China 4Department of Pathology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China  \nCorrespondence  \nChuan Wang, Jie Zhang and Fangmeng Fu, Department of Breast Surgery, Department of General Surgery, Fujian Medical University Union Hospital, Breast Cancer Institute, Fujian Medical University, 29 Xinquan Rd, Gulou District, Fuzhou, Fujian CN 350001, China.  \nEmail: [dr_chuanwang@fjmu.edu.cn](dr_chuanwang@fjmu.edu.cn), [zjie1979@fjmu.edu.cn](zjie1979@fjmu.edu.cn) and [ffm@fjmu.edu.cn](ffm@fjmu.edu.cn)  \nFunding information  \nNatural Science Foundation of Fujian Province of China, Grant/Award Number: 2023Y0020  \nAbstract  \nBackground: The prognostic relevance of HER2-low, HER2-ultralow, and null status in HER2-negative early breast cancer (eBC), and its evolution during neoadjuvant chemotherapy (NAC), remains unclear.  \nMethods: The authors analyzed 810 HER2-negative eBC patients (2011–2021) with centrally confirmed pre-and post-NAC HER2 status. Pathologic complete response (pCR, ypT0/is ypN0) rates were analyzed using logistic regression, and invasive disease-free survival (iDFS) and overall survival (OS) were evaluated via multivariable Cox proportional hazards models.  \nResults: HER2-null tumors demonstrated significantly higher rates of hormone receptor negativity, grade III histology, and Ki-67 ≥20% compared to HER2-low subgroup (p \u003C .05 for all). The pCR rates were 8.4%(HER2-low), 20.4%(HER2-ultralow), and 25.0%(HER2-null), respectively. HER2 expression inversely correlated with pCR rates across the entire cohort (odds ratio, 0. 75; 95% confidence interval [CI], 0.58–0. 98; p for trend = .033). After a median follow-up of 70.8 months, survival analysis indicated that higher HER2 expression was associated with significantly improved iDFS (hazard ratio, 0. 72; 95% CI, 0.62–0.83) and OS (hazard ratio, 0. 67; 95% CI, 0.57–0.80) in the overall population (p for trend \u003C.001 for both). Following NAC, nearly 41.0% of baseline HER2-null tumors converted to HER2-low or ultralow status. Notably, post-NAC HER2 status remained predictive of improved survival in patients with residual disease (iDFS, hazard ratio, 0. 72; 95% CI, 0.62–0.84; OS, hazard ratio, 0. 65; 95% CI, 0.55–0. 78; p for trend \u003C.001 for both). Conclusion: HER2 expression levels (low/ultralow/null) stratify prognosis in HER2-negative eBC. The dynamic evolution of HER2 status following NAC and its prognostic utility highlights the importance of reassessing HER2 status in residual disease in HER2-negative eBC.  \nYibin Qiu, Long Wu, Weifeng Cai, and Minyan Chen contributed equally to this article.  \nCancer. 2026;e70269.  \n[https://doi.org/10.1002/cncr.70269](https://doi.org/10.1002/cncr.70269)  \nwi[leyonlinelibrary.com/journal/cncr](leyonlinelibrary.com/journal/cncr)  \n© 2026 American Cancer Society.  \n1 of 13  \nKEYWORDS  \nbiomarker dynamics, HER2-low breast cancer, neoadjuvant chemotherapy, pathological complete response, survival outcomes  \nINTRODUCTION  \nBreast cancer (BC) remains the most prevalent malignancy in women globally, characterized by profound biological heterogeneity that drives divergent clinical outcomes and therapeutic responses. 1,2 Human epidermal growth fac","cbCaiugdKHGT790v","https://ap.wps.com/l/cbCaiugdKHGT790v","pdf",1459979,4,1,13,"English","en",105,"# Abstract\n## Background and Objective\n## Methods\n## Results\n## Conclusion\n# Introduction\n## Clinical Context of HER2-Negative Early Breast Cancer\n## ADC Era and Rationale for Early-Stage Biomarker Dynamics\n## Evidence Gaps and Need for Further Study","[{\"question\":\"What is the main research question of this study?\",\"answer\":\"The study evaluates how HER2-low, HER2-ultralow, and HER2-null status affects prognosis in HER2-negative early breast cancer and how this status evolves during neoadjuvant chemotherapy.\"},{\"question\":\"How were pathologic complete response and survival outcomes analyzed?\",\"answer\":\"Pathologic complete response (ypT0/is ypN0) rates were analyzed using logistic regression, while invasive disease-free survival and overall survival were assessed using multivariable Cox proportional hazards models.\"},{\"question\":\"How did HER2 expression levels relate to pCR and survival?\",\"answer\":\"HER2 expression showed an inverse association with pCR rates, and higher HER2 expression was associated with improved invasive disease-free survival and overall survival across the overall 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is the main research question of this study?","Question",{"text":75,"@type":76},"The study evaluates how HER2-low, HER2-ultralow, and HER2-null status affects prognosis in HER2-negative early breast cancer and how this status evolves during neoadjuvant chemotherapy.","Answer",{"name":78,"@type":73,"acceptedAnswer":79},"How were pathologic complete response and survival outcomes analyzed?",{"text":80,"@type":76},"Pathologic complete response (ypT0/is ypN0) rates were analyzed using logistic regression, while invasive disease-free survival and overall survival were assessed using multivariable Cox proportional hazards models.",{"name":82,"@type":73,"acceptedAnswer":83},"How did HER2 expression levels relate to pCR and survival?",{"text":84,"@type":76},"HER2 expression showed an inverse association with pCR rates, and higher HER2 expression was associated with improved invasive disease-free survival and overall survival across the overall 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