Original Article

HER2-positive grade 1 invasive carcinomas of the breast

Corresponding Author

Andrew H S Lee

[email protected]

orcid.org/0000-0003-2496-4050

Histopathology Department, Nottingham University Hospitals, City Hospital Campus, Nottingham, UK

Address for correspondence: A Lee, Histopathology Department, Nottingham University Hospitals, City Hospital Campus, Nottingham NG5 1PB, UK. e-mail: [email protected]

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Zsolt Hodi,

Zsolt Hodi

Histopathology Department, Nottingham University Hospitals, City Hospital Campus, Nottingham, UK

Source Bioscience plc., Nottingham, UK

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Areeg Abbas,

Areeg Abbas

Histopathology Department, Nottingham University Hospitals, City Hospital Campus, Nottingham, UK

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Ian O Ellis,

Ian O Ellis

orcid.org/0000-0001-5292-8474

Histopathology Department, Nottingham University Hospitals, City Hospital Campus, Nottingham, UK

Source Bioscience plc., Nottingham, UK

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Emad A Rakha,

Emad A Rakha

orcid.org/0000-0002-5009-5525

Histopathology Department, Nottingham University Hospitals, City Hospital Campus, Nottingham, UK

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Andrew H S Lee,

Corresponding Author

Andrew H S Lee

[email protected]

orcid.org/0000-0003-2496-4050

Histopathology Department, Nottingham University Hospitals, City Hospital Campus, Nottingham, UK

Address for correspondence: A Lee, Histopathology Department, Nottingham University Hospitals, City Hospital Campus, Nottingham NG5 1PB, UK. e-mail: [email protected]

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Zsolt Hodi,

Zsolt Hodi

Histopathology Department, Nottingham University Hospitals, City Hospital Campus, Nottingham, UK

Source Bioscience plc., Nottingham, UK

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Areeg Abbas,

Areeg Abbas

Histopathology Department, Nottingham University Hospitals, City Hospital Campus, Nottingham, UK

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Ian O Ellis,

Ian O Ellis

orcid.org/0000-0001-5292-8474

Histopathology Department, Nottingham University Hospitals, City Hospital Campus, Nottingham, UK

Source Bioscience plc., Nottingham, UK

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Emad A Rakha,

Emad A Rakha

orcid.org/0000-0002-5009-5525

Histopathology Department, Nottingham University Hospitals, City Hospital Campus, Nottingham, UK

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First published: 11 September 2024

https://doi.org/10.1111/his.15315

Citations: 1

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Abstract

Aims

The American Society of Clinical Oncology and College of American Pathologists HER2-guidelines recommend repeat testing for most grade 1 mammary carcinomas that are HER2-positive in the core biopsy. This study aimed to assess the value of repeat HER2-testing and the histological features of HER2-positive grade 1 carcinomas.

Methods and results

A case-series of HER2-results of grade 1 carcinomas was conducted of patients with no pre-operative systemic treatment over a 5-year period. HER2-positive carcinomas had histological review. Twelve HER2-positive carcinomas were initially reported as grade 1. On review, two were reclassified as grade 2. The remaining 10 carcinomas represented 2% of the 508 grade 1 carcinomas. Eight HER2-positive grade 1 carcinomas from other years were also studied. HER2-positive carcinomas more often had marked nuclear pleomorphism (50 versus 6%) and were more often oestrogen receptor-negative (17 versus 0.8%) and progesterone receptor-negative (28 versus 8%) compared with HER2-negative grade 1 carcinomas. Six carcinomas that were HER2 3+ in the core biopsy were also 3+ on repeat assessment. Five of seven carcinomas that were 2+ amplified in the core biopsy were also HER2-positive in the excision.

Conclusions

HER2-positive grade 1 carcinomas are uncommon, and more often have marked nuclear pleomorphism and lack oestrogen receptor and progesterone receptor expression compared with HER2-negative grade 1 carcinomas. A HER2-poitive result in the core biopsy was confirmed in 11 of 13 tumours that had repeat testing.

Graphical Abstract

HER2-positive grade 1 carcinomas are uncommon and more often have marked nuclear pleomorphism and lack oestrogen receptor and progesterone receptor expression compared with HER2-negative grade 1 carcinomas. A HER2-positive result in the core biopsy was confirmed in 11 of 13 tumours that had repeat testing.

Conflicts of interest

The authors declare they have no conflicts of interest.

Open Research

Data availability statement

Data will be supplied on reasonable request. Most of the data are included in the paper.

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Citing Literature

Volume86, Issue2

January 2025

Pages 278-284