{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:42:09Z","timestamp":1778823729062,"version":"3.51.4"},"reference-count":37,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T00:00:00Z","timestamp":1766275200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82172835"],"award-info":[{"award-number":["82172835"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Purpose: This study investigates receptor status changes following neoadjuvant chemotherapy (NAC) in breast cancer, aiming to identify new therapeutic opportunities and improve human epidermal growth factor receptor 2 (HER2) detection and categorization methods. Methods: This retrospective analysis was conducted on patients with breast cancer who underwent NAC and surgery between July 2022 and June 2024. Chi-square tests and logistic regression models were applied to assess the associations between HER2 status changes and clinicopathological features. Results: Among 508 patients, the receptor discordance rates after NAC were 5.3% for estrogen receptor (ER), 21.3% for progesterone receptor (PR), and 43.7% for HER2. Ki-67 expression decreased in 64.6% of cases and increased in 6.8%. Of the 103 patients with HER2-0, 47 (45.6%) transitioned to IHC 1+, 9 (8.7%) to IHC 2+\/ISH\u2212, and 1 (1.0%) to IHC 2+\/ISH+. Among 256 patients with HER2 IHC 1+, 58 (22.7%) transitioned to IHC 2+\/ISH\u2212, 36 (14.1%) to IHC 0, and 9 (3.5%) to IHC 2+\/ISH+. For 149 patients with HER2 IHC 2+\/ISH\u2212, 50 (33.6%) transitioned to IHC 1+, 6 (4.0%) to IHC 2+\/ISH+, 5 (3.4%) to IHC 0, and 1 (0.7%) to IHC 3+. Univariate analysis revealed that, when compared to grade III tumors, grade I\u2013II tumors exhibited a higher rate of HER2-0 to HER2-low conversion (66.7% vs. 36.8%, p = 0.027). HER2-low to HER2-0 conversion was associated with ER negativity (p = 0.028), PR negativity (p = 0.021), HER2 IHC 1+ (vs. IHC 2+, p = 0.001), and TIL &gt;10% (p = 0.049). Multivariate analysis revealed that tumors with HER2 IHC 1+ were more likely to convert to HER2-0 after NAC than those with HER2 IHC 2+ (p = 0.020). Conclusions: Following NAC, ER gain, PR loss, and Ki-67 reduction were common. HER2 and ER status changes predominantly occurred within adjacent expression intensity levels.<\/jats:p>","DOI":"10.3390\/curroncol33010006","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T14:27:47Z","timestamp":1766500067000},"page":"6","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Changes in HER2, ER, PR, and Ki-67 in HER2-Negative Breast Cancer After Neoadjuvant Chemotherapy: A Case\u2013Control Study"],"prefix":"10.3390","volume":"33","author":[{"given":"Youzhao","family":"Ma","sequence":"first","affiliation":[{"name":"The First Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Huan-Hu-Xi Road, He-Xi District, Tianjin 300060, China"},{"name":"Tianjin\u2019s Clinical Research Center for Cancer, Tianjin Medical University, Tianjin 300060, China"},{"name":"Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin 300060, China"},{"name":"Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China"},{"name":"Department of Breast Disease, Henan Breast Cancer Center, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, No. 127, Dongming Road, Zhengzhou 450000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of General Surgery, The Second Hospital of Chifeng, Chifeng 024000, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mingda","family":"Zhu","sequence":"additional","affiliation":[{"name":"Fudan University Pudong Medical Center, Shanghai Pudong Hospital, 2800 Gongwei Road, Pudong, Shanghai 201399, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Yu","sequence":"additional","affiliation":[{"name":"The First Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Huan-Hu-Xi Road, He-Xi District, Tianjin 300060, China"},{"name":"Tianjin\u2019s Clinical Research Center for Cancer, Tianjin Medical University, Tianjin 300060, China"},{"name":"Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin 300060, China"},{"name":"Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Department of Breast Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Huan-Hu-Xi Road, He-Xi District, Tianjin 300060, China"},{"name":"Tianjin\u2019s Clinical Research Center for Cancer, Tianjin Medical University, Tianjin 300060, China"},{"name":"Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Tianjin 300060, China"},{"name":"Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University, Tianjin 300060, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,21]]},"reference":[{"key":"ref_1","first-page":"17","article-title":"Cancer statistics, 2023","volume":"73","author":"Siegel","year":"2023","journal-title":"CA Cancer J. 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