{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T18:37:10Z","timestamp":1775673430362,"version":"3.50.1"},"reference-count":19,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T00:00:00Z","timestamp":1607385600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007188","name":"Uniformed Services University","doi-asserted-by":"publisher","award":["HU0001-16-2-0004"],"award-info":[{"award-number":["HU0001-16-2-0004"]}],"id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Genes"],"abstract":"<jats:p>In 2010, the genetic testing criteria was changed to allow women diagnosed \u2264 60 years old with triple negative breast cancer (TNBC) to undergo germline testing. In the same year, estrogen receptor (ER) positivity was defined as having \u22651% ER staining cells. While tumors with 1\u201310% ER staining cells and HER2 negative (HER2-) status share characteristics with TNBC, the utility of germline testing in women with ER low positive\/HER2- (ERLP\/HER2-) tumors is not well-understood. To this end, all patients with hormone receptor positive staining cells \u2264 10% and negative HER2 status were identified. Clinical genetic test results were extracted for patients who underwent testing. Panel testing was performed for those women who had genomic DNA available for research purposes. ERLP\/HER2-tumors constituted 2.7% of all tumors in the database. Patients did not differ significantly from those with TNBC by age at diagnosis, ethnicity, family history or tumor size, stage or grade (p &gt; 0.05). Mutation frequency did not differ significantly (p = 0.757) between groups (ERLP\/HER2- 16.1%; TNBC 16.7%). Hereditary forms of breast cancer were similar in both ERLP\/HER2- and TNBC, thus current guidelines may result in the under testing of women with low ER tumors, resulting in missed opportunities to improve patient management.<\/jats:p>","DOI":"10.3390\/genes11121469","type":"journal-article","created":{"date-parts":[[2020,12,8]],"date-time":"2020-12-08T11:50:49Z","timestamp":1607428249000},"page":"1469","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Heritability of Low ER Staining\/HER2-Breast Tumors: Are We Missing an Opportunity for Germline Testing?"],"prefix":"10.3390","volume":"11","author":[{"given":"Leann A.","family":"Lovejoy","sequence":"first","affiliation":[{"name":"Chan Soon-Shiong Institute for Molecular Medicine at Windber, Windber, PA 15963, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clesson E.","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin M.","family":"Wells","sequence":"additional","affiliation":[{"name":"Department of Pathology, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8993-5811","authenticated-orcid":false,"given":"Craig D.","family":"Shriver","sequence":"additional","affiliation":[{"name":"Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA"},{"name":"Murtha Cancer Center\/Research Program, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, MD 20814, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2287-1635","authenticated-orcid":false,"given":"Rachel E.","family":"Ellsworth","sequence":"additional","affiliation":[{"name":"Murtha Cancer Center\/Research Program, Uniformed Services University of the Health Sciences and Walter Reed National Military Medical Center, Bethesda, MD 20814, USA"},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Windber, PA 15963, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2638","DOI":"10.1002\/cncr.23930","article-title":"Sites of distant recurrence and clinical outcomes in patients with metastatic triple-negative breast cancer: High incidence of central nervous system metastases","volume":"113","author":"Lin","year":"2008","journal-title":"Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1007\/s10549-014-2980-0","article-title":"Germline BRCA mutation evaluation in a prospective triple-negative breast cancer registry: Implications for hereditary breast and\/or ovarian cancer syndrome testing","volume":"145","author":"Sharma","year":"2014","journal-title":"Breast Cancer Res. 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