Hi there,
Can you confirm how thinking has changed over the last few years regarding HER2 scores. I’ve read that scores that were previously considered to be HER2 negative are now classed as HER2 low.
My score was 1+ which four years ago I was told was HER2 negative. I’ve since read that today a score of 1+ is not negative but HER2 low. I’m a bit worried. What does this now mean and will it affect treatment?
Thanks.
Frances
Hi,
The her2 positive/negative was initially introduced to differentiate between women whose breast cancer would benefit from treatment with herceptin ( which is given to her2 positive women). The HIC test gives results of 0, +1, +2 or +3. Her2 is positive if IHC +3 or IHC +2 and has an equitable fish test as the Her2 drugs can be affective on these breast cancers. However new drugs which are used in the metastatic setting have been shown to benefit her2 low breast cancers which are IHC+1 and IHC+2 which have an unequivocal fish test. I believe they are on going trials to see if these drugs will benefit HER2 low primary breast cancers. I think the trial which started this interest in her2 low breast cancer was the Destiny 4 trial, which when given to metastatic her2 low women the new drug, they survived longer.
This is my understanding and if it’s not correct I’m sure someone will correct me.
Hi Frances,
Thank you for posting your question about HER2 low breast cancer.
Traditionally, when breast cancer cells are tested for the HER2 protein the result has been described as HER2 positive or HER2 negative. More recently, if cancer cells express a low level of the HER2 protein they can be classed as HER2 low, as you have read.
There is some evidence that HER2-low breast cancer may benefit from targeted treatments, such as trastuzumab. However, more research is needed.
At the present time, targeted treatment for HER2 low breast cancer is not yet available outside of a clinical trial for people with primary breast cancer, as @shade has said. For people with secondary (metastatic) breast cancer, the targeted drug Enhertu has been shown to have some benefit, however this has not been approved for use in England.
It’s understandable that you have questions about this. Do call your breast care nurse to talk this through, they may be able to arrange an appointment with your treatment team to talk through the questions you have.
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