Human epidermal growth factor receptor 2 (HER2) status in breast cancer: practice points and challenges

Author:

Laokulrath Natthawadee12,Gudi Mihir2,Salahuddin Syed Ahmed3,Chong Angela Phek Yoon4,Ding Cristine5,Iqbal Jabed3ORCID,Leow Wei Qiang36,Tan Benjamin Yongcheng3ORCID,Tse Gary7,Rakha Emad8ORCID,Tan Puay Hoon29ORCID

Affiliation:

1. Department of Pathology, Siriraj Hospital Mahidol University Bangkok Thailand

2. Department of Pathology and Laboratory Medicine KK Women's and Children's Hospital Singapore

3. Department of Anatomical Pathology Singapore General Hospital Singapore

4. Department of Pathology Sengkang General Hospital Singapore

5. Division of Anatomical Pathology Changi General Hospital Singapore

6. Duke‐NUS Medical School Singapore

7. Department of Anatomical and Cellular Pathology, Prince of Wales Hospital The Chinese University of Hong Kong Shatin Hong Kong

8. Cellular Pathology Department, School of Medicine University of Nottingham Nottingham UK

9. Luma Medical Centre Singapore

Abstract

Human epidermal growth factor receptor 2 (HER2)‐enriched breast cancer benefits significantly from anti‐HER2 targeted therapies. This highlights the critical need for precise HER2 immunohistochemistry (IHC) interpretation serving as a triage tool for selecting patients for anti‐HER2 regimens. Recently, the emerging eligibility of patients with HER2‐low breast cancers for a novel HER2‐targeted antibody–drug conjugate (T‐DXd) adds challenges to HER2 IHC scoring interpretation, notably in the 0–1+ range, which shows high interobserver and interlaboratory staining platform variability. In this review, we navigate evolving challenges and suggest practical recommendations for HER2 IHC interpretation.

Publisher

Wiley

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