---
title: "Frequency and implications of HER2 status change after neoadjuvant HER2-targeted therapy in breast"
id: "pubmed-42803995"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42803995"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42803995/"
doi: "10.1007/s10549-026-08088-z"
published_at: "2026-09-28T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Frequency and implications of HER2 status change after neoadjuvant HER2-targeted therapy in breast
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42803995
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42803995/)
- **DOI:** [10.1007/s10549-026-08088-z](https://doi.org/10.1007%2Fs10549-026-08088-z)
- **Published At:** 2026-09-28T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This retrospective single-institution study evaluated **HER2** status in residual invasive breast carcinoma after **neoadjuvant HER2-targeted therapy (NAT)** in patients initially diagnosed with HER2-positive disease. - Between 2016 and 2025, 161 HER2-positive patients received HER2-targeted NAT; 65 had adequate residual invasive tumor available for post-treatment HER2 assessment. - Post-NAT assessment used **immunohistochemistry (IHC)** for all cases; IHC 2+ cases were reflex-tested by **FISH** to determine gene amplification. - Tumors were classified as HER2-retained (IHC 3+ or IHC 2+/FISH amplified) or HER2-change (IHC 0/1+ or IHC 2+/FISH non-amplified). - Retained HER2 overexpression was observed in 28/65 cases (43%); HER2 status change (loss of overexpression) occurred in 37/65 cases (57%). - Pre-NAT hormone receptor positivity was common in both groups: 23/28 (82.1%) in the HER2-retained group and 33/37 (89.2%) in the HER2-change group. - The study found no major differences in reported clinicopathologic parameters between HER2-retained and HER2-change groups based on the data provided. - Current national and international guidelines recommend adjuvant HER2-targeted therapy regardless of post-treatment HER2 status. - Authors conclude that loss of HER2 overexpression after HER2-targeted NAT is frequent and call for prospective randomized phase II/III trials to define the benefit of adjuvant HER2-targeted therapy in patients whose residual tumor no longer overexpresses HER2. - The analysis is limited by its retrospective design and being from a single institution; further prospective evidence is needed to guide adjuvant treatment decisions in this subgroup.
## Clinical Analysis & Structured Key Points
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HER2 status change in residual breast carcinoma after neoadjuvant HER2-targeted therapy in patients with HER2-positive breast cancer [Payu Raval](https://pubmed.ncbi.nlm.nih.gov/?term=Raval+P&cauthor_id=42803995)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#full-view-affiliation-1 "Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Qingqing Ding](https://pubmed.ncbi.nlm.nih.gov/?term=Ding+Q&cauthor_id=42803995)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#full-view-affiliation-1 "Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Puneet Singh](https://pubmed.ncbi.nlm.nih.gov/?term=Singh+P&cauthor_id=42803995)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#full-view-affiliation-2 "Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Alaaeddin Alrohaibani](https://pubmed.ncbi.nlm.nih.gov/?term=Alrohaibani+A&cauthor_id=42803995)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#full-view-affiliation-3 "Department of Pathology and Translational Pathobiology, LSU Health Shreveport, Houston, USA."), [Hongxia Sun](https://pubmed.ncbi.nlm.nih.gov/?term=Sun+H&cauthor_id=42803995)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#full-view-affiliation-1 "Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Di Ai](https://pubmed.ncbi.nlm.nih.gov/?term=Ai+D&cauthor_id=42803995)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#full-view-affiliation-1 "Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Kerollos Nashat Wanis](https://pubmed.ncbi.nlm.nih.gov/?term=Wanis+KN&cauthor_id=42803995)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#full-view-affiliation-2 "Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Ming Zhao](https://pubmed.ncbi.nlm.nih.gov/?term=Zhao+M&cauthor_id=42803995)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#full-view-affiliation-4 "Department of School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Hui Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+H&cauthor_id=42803995)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#full-view-affiliation-1 "Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Vicente Valero](https://pubmed.ncbi.nlm.nih.gov/?term=Valero+V&cauthor_id=42803995)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#full-view-affiliation-5 "Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Mariana Chavez-MacGregor](https://pubmed.ncbi.nlm.nih.gov/?term=Chavez-MacGregor+M&cauthor_id=42803995)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#full-view-affiliation-5 "Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Aysegul Sahin](https://pubmed.ncbi.nlm.nih.gov/?term=Sahin+A&cauthor_id=42803995)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#full-view-affiliation-6 "Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. asahin@mdanderson.org.") Affiliations Expand ### Affiliations * 1 Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. * 2 Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. * 3 Department of Pathology and Translational Pathobiology, LSU Health Shreveport, Houston, USA. * 4 Department of School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. * 5 Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. * 6 Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. asahin@mdanderson.org. * PMID: **42803995** * DOI: [ 10.1007/s10549-026-08088-z ](https://doi.org/10.1007/s10549-026-08088-z) Item in Clipboard # HER2 status change in residual breast carcinoma after neoadjuvant HER2-targeted therapy in patients with HER2-positive breast cancer Payu Raval et al. Breast Cancer Res Treat. 2026. Show details Display options Display options Format Abstract PubMed PMID Breast Cancer Res Treat Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Breast+Cancer+Res+Treat%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Breast+Cancer+Res+Treat%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803995/) . 2026 Sep 28;219(3):25. doi: 10.1007/s10549-026-08088-z. ### Authors [Payu Raval](https://pubmed.ncbi.nlm.nih.gov/?term=Raval+P&cauthor_id=42803995)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#short-view-affiliation-1 "Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Qingqing Ding](https://pubmed.ncbi.nlm.nih.gov/?term=Ding+Q&cauthor_id=42803995)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#short-view-affiliation-1 "Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Puneet Singh](https://pubmed.ncbi.nlm.nih.gov/?term=Singh+P&cauthor_id=42803995)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#short-view-affiliation-2 "Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Alaaeddin Alrohaibani](https://pubmed.ncbi.nlm.nih.gov/?term=Alrohaibani+A&cauthor_id=42803995)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#short-view-affiliation-3 "Department of Pathology and Translational Pathobiology, LSU Health Shreveport, Houston, USA."), [Hongxia Sun](https://pubmed.ncbi.nlm.nih.gov/?term=Sun+H&cauthor_id=42803995)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#short-view-affiliation-1 "Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Di Ai](https://pubmed.ncbi.nlm.nih.gov/?term=Ai+D&cauthor_id=42803995)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#short-view-affiliation-1 "Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Kerollos Nashat Wanis](https://pubmed.ncbi.nlm.nih.gov/?term=Wanis+KN&cauthor_id=42803995)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#short-view-affiliation-2 "Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Ming Zhao](https://pubmed.ncbi.nlm.nih.gov/?term=Zhao+M&cauthor_id=42803995)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#short-view-affiliation-4 "Department of School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Hui Chen](https://pubmed.ncbi.nlm.nih.gov/?term=Chen+H&cauthor_id=42803995)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#short-view-affiliation-1 "Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Vicente Valero](https://pubmed.ncbi.nlm.nih.gov/?term=Valero+V&cauthor_id=42803995)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#short-view-affiliation-5 "Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Mariana Chavez-MacGregor](https://pubmed.ncbi.nlm.nih.gov/?term=Chavez-MacGregor+M&cauthor_id=42803995)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#short-view-affiliation-5 "Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA."), [Aysegul Sahin](https://pubmed.ncbi.nlm.nih.gov/?term=Sahin+A&cauthor_id=42803995)[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42803995/#short-view-affiliation-6 "Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. asahin@mdanderson.org.") ### Affiliations * 1 Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. * 2 Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. * 3 Department of Pathology and Translational Pathobiology, LSU Health Shreveport, Houston, USA. * 4 Department of School of Health Professions, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. * 5 Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. * 6 Department of Anatomical Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. asahin@mdanderson.org. * PMID: **42803995** * DOI: [ 10.1007/s10549-026-08088-z ](https://doi.org/10.1007/s10549-026-08088-z) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID Linked Discoveries ## Abstract **Purpose:** Assessment of HER2 status change in HER2-positive breast carcinoma (BC) prior to and after HER2-targeted neoadjuvant therapy (NAT) may potentially impact adjuvant HER2-targeted therapy. Reported rates of HER2 status change vary widely ( - [DOI](https://doi.org/10.1016/j.annonc.2021.05.005) 2. 1. Tchou J, Gottipati S, Goldbach M et al (2024) Change in biomarker profile after neoadjuvant chemotherapy is prognostic and common among patients with HER2 + breast cancer. Ann Surg Oncol 31:8093–8101. - [DOI](https://doi.org/10.1245/s10434-024-15332-0) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/39117925/) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/11467097/) 3. 1. Geyer CE, Untch M, Huang CS et al (2025) Survival with trastuzumab emtansine in residual HER2-positive breast cancer. N Engl J Med 392:249–257. - [DOI](https://doi.org/10.1056/nejmoa2406070) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/39813643/) 4. 1. Loibl S, Park YH, Shao Z et al (2026) Trastuzumab deruxtecan in residual HER2-positive early breast cancer. N Engl J Med 394:845–857. - [DOI](https://doi.org/10.1056/nejmoa2514661) - [PubMed](https://pubmed.ncbi.nlm.nih.gov/41370739/) 5. 1. Uczkowski D, Sekhri A, Gupta S et al (2023) Treatment of HER2 + breast cancer: prognosis with loss of HER2 amplification after neoadjuvant therapy. Am J Cancer Res 13:2564–2571 - [PubMed](https://pubmed.ncbi.nlm.nih.gov/37424818/) - [PMC](https://pmc.ncbi.nlm.nih.gov/articles/10326587/) Show all 35 references ## MeSH terms * Adult Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Adult%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Adult) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803995/) * Aged Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Aged%22%5BMeSH%5D&sort=date&sort_order=desc) * [ Search in MeSH ](https://www.ncbi.nlm.nih.gov/mesh?term=Aged) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42803995/) * Biomarkers, Tumor Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Biomarkers%2C+Tumor
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