Diagnosis and Treatment of HER2-Negative Breast Cancer

Dear Colleagues,

HER2-Negative Breast Cancer is the most frequent subtype of breast cancer, and its correct identification is very important because it requires different prognosis and treatment. The standard diagnostic procedure is based on the immunohistochemistry of estrogen and progesterone receptors and HER2 protein, but for a correct identification, we could use one of the genomics platforms, such as oncotype, prosigna or mamaprint.

As mentioned, correct classification of the subtype is very important due to the treatment approach being different. HER2-Negative Breast Cancer is considered as luminal-like, but there could be some mistakes and some patients are reclassified as non-luminal with this genomic platform. Another important consideration is that luminal patients should be reclassified as luminal A or luminal B with the different genomics platforms with a different therapeutic approach—normally luminal A patients are more endocrine sensitive so they will not require chemotherapy treatment; inversely, luminal B patients are less endocrine sensitive and will require chemotherapy.

In addition, important advances have been made in this subtype, highlighting the knowledge of the molecular pathways of the endocrine mechanism of tumor development that has motivated the development of new therapeutic targets with the consequent benefit to these patients; therefore, it is very important to know these mechanisms in order to correctly apply these new targeted treatments. One of the most interesting new drugs is the family of cyclin inhibitors (palbociclib, ribociclib and abemaciclib) that have achieved a notable paradigm shift, doubling survival times in this subtype in advanced breast cancer, so it will be very important to introduce them into our routine practice.

Prof. Dr. Serafín M. Morales
Dr. Ariadna Gasol Cudos
Dr. Douglas Rene Sanchez Guzman
Guest Editors

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• breast cancer
• endocrine therapy
• biomarkers
• molecular subtypes
• genomics platforms
• molecular pathways
• targeted therapies
• cyclin inhibitors