{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,12]],"date-time":"2026-04-12T17:45:39Z","timestamp":1776015939790,"version":"3.50.1"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T00:00:00Z","timestamp":1772755200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>HER2\u2010low breast cancer (BC) has recently emerged as a therapeutically targetable entity, yet its biological and clinical relevance remains debatable. Limited data are available about HER2\u2010low from non\u2010Western populations, particularly the Middle East, where distinct tumor biology may influence phenotype and treatment response.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We retrospectively analyzed 1097 Saudi breast cancer patients for HER2 status by immunohistochemistry (IHC), classifying tumors as HER2\u2010zero (IHC 0) or HER2\u2010low (IHC 1+\/2+ and FISH\u2010negative). Clinicopathological characteristics, biomarker profiles (ER, PR, Ki\u201067), molecular alterations (\n                      <jats:italic>PIK3CA<\/jats:italic>\n                      ,\n                      <jats:italic>TP53<\/jats:italic>\n                      ,\n                      <jats:italic>BRCA<\/jats:italic>\n                      ) and survival outcomes (overall survival (OS), cancer\u2010specific survival (CSS), disease\u2010free survival (DFS), and distant disease\u2010free survival (DDFS)) were compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      HER2\u2010low tumors comprised 34.5% (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a0378) of the cohort and were significantly associated with ER (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001) and PR (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0226) positivity, lower triple\u2010negative phenotype (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001), and reduced Ki\u201067 proliferation index (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0136) compared to HER2\u2010zero tumors. Trends toward higher\n                      <jats:italic>PIK3CA<\/jats:italic>\n                      mutation (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0875) and lower\n                      <jats:italic>BRCA<\/jats:italic>\n                      mutation (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.0892) rates were observed in HER2\u2010low tumors, though not statistically significant. Despite these favorable biological features, survival analyses revealed no significant differences between HER2\u2010low and HER2\u2010zero subtypes with regards to OS, CSS, DFS, and DDFS.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large, ethnically homogenous Saudi cohort, HER2\u2010low breast cancer represents a distinct molecular and clinicopathological subtype with luminal like features, yet no prognostic advantage. These findings reinforce the therapeutic, rather than prognostic, significance of HER2\u2010low status, highlighting its relevance in targeted antibody\u2013drug conjugate\u2010based therapies rather than influencing baseline risk stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/wjs.70267","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:21:00Z","timestamp":1773008460000},"page":"796-802","source":"Crossref","is-referenced-by-count":0,"title":["Clinicopathological Landscape and Survival Outcomes of HER2\u2010Low Breast Cancer in a Large Arab Cohort"],"prefix":"10.1002","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2162-6857","authenticated-orcid":false,"given":"Abdul K.","family":"Siraj","sequence":"first","affiliation":[{"name":"Human Cancer Genomic Research King Faisal Specialist Hospital and Research Center  Riyadh Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep 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