171P - Transcriptomic stratification of breast carcinomas with double-equivocal HER2 status

Date 10 October 2016
Event ESMO 2016 Congress
Session Poster display
Topics Breast Cancer
Presenter Caterina Marchio
Citation Annals of Oncology (2016) 27 (6): 43-67. 10.1093/annonc/mdw364
Authors C. Marchio1, P. Dell'Orto2, L. Annaratone1, N. Rangel1, A. Özgüzer3, L. Verdun Di Cantogno4, A. Sapino3, G. Viale2
  • 1Department Of Medical Sciences, Università degli Studi di Torino, 10126 - Torino/IT
  • 2Pathology, University of MIlan, European Institute of Oncology, 20141 - Milan/IT
  • 3Pathology Unit, Istituto di Candiolo-IRCCS-Fondazione Piemontese per la Ricerca sul Cancro-Onlus, 10060 - Candiolo/IT
  • 4Pathology Unit, Città della Saluta e della Scienza - Torino, 10126 - Torino/IT



The evaluation of HER2 overexpression and amplification in breast cancer (BC) provides a validated predictor of response to anti-HER2 agents. However, the algorithm based on immunohistochemistry (IHC) and in situ hybridization (ISH) still identifies a category of carcinomas that remain equivocal after ISH testing (“double equivocal” carcinomas). These carcinomas represent a real challenge for oncologists, who have to face the dilemma “to treat or not to treat”. The ASCO/CAP guidelines stress the need for data defining their biology and clinical behavior. Our aim was to stratify double-equivocal BCs by using transcriptomics.


We retrieved a series of 28 formalin fixed paraffin embedded double-equivocal BCs, i.e. showing HER2/CEP17 ratio 


All cases were estrogen receptor positive and 68% showed progesterone receptor expression in more than 20% of tumor cells. The large majority of double equivocal BCs were classified by Prosigna as pertaining to the Luminal B molecular subgroup (23/28, 82%); three cases (11%) were classified as Luminal A and two cases (7%) as HER2-enriched. These carcinomas frequently (23/28, 82%) showed a high risk of recurrence (ROR) even when the analysis was restricted to node negative BCs showing a tumor size


Double equivocal BCs preferentially pertain to the Luminal B rather than to the HER2-enriched molecular subgroup. Nevertheless, our data show that these luminal B carcinomas, even when node negative and of small tumor size, preferentially harbor a high risk of recurrence. This transcriptomic stratification may help in the treatment decision making of this controversial category of BC.

Clinical trial identification

Legal entity responsible for the study

University of Turin


Italian Association for Cancer Research


All authors have declared no conflicts of interest.