Clinicopathological features of and neoadjuvant therapy for human epidermal growth factor receptor 2-positive classic invasive lobular carcinoma

Hum Pathol. 2021 Nov:117:51-59. doi: 10.1016/j.humpath.2021.07.010. Epub 2021 Aug 5.

Abstract

Human epidermal growth factor receptor 2 (HER2)-positive classic invasive lobular carcinoma (ILC) is a rare entity, and its specific pathological characteristics and clinical behavior are unclear. Therefore, we retrospectively investigated the clinicopathological features of HER2-positive classic ILC and described HER2-targeted neoadjuvant chemotherapy outcome. Fourteen HER2-positive classic ILC cases were identified, their clinicopathological data were collected, and their clinical management was investigated. In general, HER2 positivity is associated with higher grade carcinoma in ductal lesions; however, our 14 cases had typical morphologic features of classic ILC. We did not identify unique morphologic features in HER2-positive classic ILC with the clinicopathological parameters examined, including age, menopausal status, histological grade, and hormone receptor status. Four of six patients who received HER2-targeted neoadjuvant chemotherapy had a pathological complete or partial response. Based on our findings, clinicopathological features of classic ILC may not predict HER2 overexpression or amplification. HER2-targeted neoadjuvant chemotherapy was effective against some HER2-positive classic ILCs. Taken together, these results demonstrate that HER2 immunohistochemistry and fluorescence in situ hybridization should be considered for all ILC patients regardless of subtype.

Keywords: Breast; HER2; Invasive lobular carcinoma; Neoadjuvant therapy.

MeSH terms

  • Aged
  • Antineoplastic Agents / therapeutic use
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / genetics*
  • Breast Neoplasms / pathology*
  • Carcinoma, Lobular / drug therapy
  • Carcinoma, Lobular / genetics*
  • Carcinoma, Lobular / pathology*
  • Female
  • Humans
  • Middle Aged
  • Molecular Targeted Therapy / methods
  • Neoadjuvant Therapy / methods
  • Receptor, ErbB-2* / genetics
  • Receptor, ErbB-2* / metabolism
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • ERBB2 protein, human
  • Receptor, ErbB-2