From the Guidelines
HER2-positive breast cancer has a comparable or sometimes better prognosis than HER2-negative breast cancer when treated with current targeted therapies. Historically, HER2-positive tumors have been associated with faster growth rates, higher recurrence rates, increased likelihood of metastasis, and poorer overall survival 1. However, the introduction of HER2-targeted therapies has significantly improved outcomes in patients with HER2-positive early and metastatic breast cancer, narrowing the prognostic difference between HER2-positive and HER2-negative breast cancer 1.
Some key points to consider when evaluating the prognosis of HER2-positive versus HER2-negative breast cancer include:
- The development of targeted therapies like trastuzumab, pertuzumab, and T-DM1, which have improved survival rates for HER2-positive patients 1
- The importance of considering factors beyond HER2 status, such as tumor size, grade, lymph node involvement, hormone receptor status, and the patient's overall health and age 1
- The increased incidence of brain metastases in HER2-positive breast cancer due to improved systemic therapy and longer patient survival 1
According to the most recent and highest quality study, the 12-year overall survival rate for HER2-positive early breast cancer was 79% with adjuvant trastuzumab, compared to 73% without trastuzumab 1. Additionally, the 8-year overall survival rate for HER2-positive metastatic breast cancer was 37% with trastuzumab, pertuzumab, and docetaxel, compared to 23% with trastuzumab and docetaxel 1. These findings suggest that HER2-positive breast cancer can have a comparable or sometimes better prognosis than HER2-negative breast cancer when treated with current targeted therapies.
From the Research
Prognosis of HER2-Positive and Negative Breast Cancer
- The prognosis of HER2-positive breast cancer has improved significantly with the introduction of HER2-targeted therapies 2, 3, 4, 5, 6.
- Studies have shown that HER2-positive breast cancer is no longer a marker of poor prognosis if access to HER2-targeted therapies is granted 2.
- In fact, the overall survival of HER2-positive breast cancer patients has approached that of luminal subtype breast cancer patients with the use of HER2-targeted therapies 2.
- However, HER2-negative breast cancer patients who are PAM50-HER2-enriched may have a lower overall survival compared to HER2-positive patients who receive HER2-targeted therapies 2.
- The treatment landscape of HER2-positive breast cancer is constantly evolving, with several novel therapies being investigated and showing promising results 4, 5, 6.
Comparison of Prognosis
- Before the introduction of HER2-targeted therapies, HER2-positive breast cancer had a significantly worse prognosis compared to HER2-negative breast cancer 2.
- However, with the use of HER2-targeted therapies, the prognosis of HER2-positive breast cancer has improved dramatically, and it is no longer considered a marker of poor prognosis 2, 3, 4, 5, 6.
- In contrast, HER2-negative breast cancer patients who are PAM50-HER2-enriched may have a poorer prognosis compared to HER2-positive patients who receive HER2-targeted therapies 2.
Current Treatment Options
- The current standard treatment for HER2-positive breast cancer includes HER2-targeted therapies such as trastuzumab, pertuzumab, and trastuzumab deruxtecan 3, 4, 5, 6.
- The treatment options for HER2-negative breast cancer depend on various factors, including the hormone receptor status and the presence of other molecular markers 2, 4, 5, 6.