Association of Peritumoral Radiomics With Tumor Biology and Pathologic Response to Preoperative Targeted Therapy forHER2 (ERBB2)–Positive Breast Cancer

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Abstract
Human epidermal growth factor receptor 2 (currently known as ERBB2, but referred to as HER2 in this study)–positive breast cancer is morphologically and genetically heterogeneous. Not all patients will fully benefit from HER2-targeted treatment, with less than 35% of patients initially responding to therapy with the monoclonal antibody trastuzumab.1,2 Molecular profiling via tests such as the PAM50 gene set can provide insight into treatment response by subcategorizing HER2-positive (HER2+) tumors into response-associated intrinsic molecular subtypes.3-8 The HER2-enriched (HER2-E) subtype, composing 40% to 50% of HER2+ breast cancers, is of particular therapeutic interest owing to its elevated rate of response to HER2-targeted therapy.3,9,10 Although molecular subtyping of HER2+ breast cancer is gradually gaining biological significance, no clinically accepted biomarkers are as yet available for prediction of response to anti-HER2 therapy.11 Therefore, there remains a need to develop novel approaches to estimate clinical outcomes of HER2-targeted therapy.

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