HER2+ recurrence & survival data

Last updated: August 31, 2023

HER2+ breast cancer recurrence & survival

Below we summarize data published since 2019 concerning survival and risk of recurrence of women with early-stage invasive HER2 overexpressing (HER2+ or ERBB2) breast cancer. However, please note that outcomes can vary depending on numerous factors. Also, the data represents snapshots from studies that were conducted using different populations under a variety of circumstances.

Furthermore, most studies that calculate survival do not present the results as simple percentages. Therefore, the numbers below are somewhat inconsistent and far from complete or definitive and should not be used to calculate your likely recurrence-free survival. However, the statistics are useful in getting a general idea of HER2+ breast cancer prognosis and to compare outcomes depending on treatment and other factors. For example, the data suggests that patients who do not achieve a pathologic complete response to neoadjuvant chemotherapy have worse outcomes and therefore might benefit from additional monitoring and treatment.

Definition of recurrence & survival terms

Overall survival means that no death occurred from any cause (this includes deaths from both breast cancer and non-breast cancer-specific causes). Breast cancer-specific survival refers to the percentage of patients who did not die from breast cancer during the specified period. Progression-free survival means that no recurrence, metastasis or breast cancer-related death took place during the specified period. Recurrence-free survival was defined by the authors who used the term in one study as no recurrence, metastasis or breast cancer-related death, however a second primary cancer might have been diagnosed during follow up. PCR or minimal residual cancer burden (RCB-I) means no or very little remaining microscopic evidence of viable cancer cells in tissue biopsied after treatment.

HER2+ breast cancer recurrence & survival data

Patient & treatment characteristics → Likelihood of 5-year survival

ER+/PR+/HER2+ receptor status

5-year survival
- ER+/PR+/HER2+ Overall survival → 84%
- ER+/PR+/HER2+ Breast cancer-specific survival → 91%
5-year progression-free survival based on chemotherapy
- ER+/PR+/HER2+ Adjuvant chemotherapy, no Herceptin → 56%
- ER+/PR+/HER2+ Neoadjuvant chemotherapy, no Herceptin → 65%
- ER+/PR+/HER2+ Neoadjuvant chemotherapy plus Herceptin → 89%
5-year progression-free survival based on residual disease
- ER+/PR+/HER2+ RCB-I after neoadjuvant treatment → 93% to 98%
- ER+/PR+/HER2+ Moderate residual cancer burden (RCB-II) → 78%
- ER+/PR+/HER2+ Extensive residual cancer burden (RCB-III) → 49%
5-year progression-free survival based on degree of ER & PR positivity
- ER+/PR+/HER2+ Both ER and PR scores ≥ 50%, adjuvant chemotherapy plus Herceptin → 75%
- ER+/PR+/HER2+ ER and/or PR scores < 50%, adjuvant chemotherapy plus Herceptin → 81%

ER-/PR-/HER2+ receptor status

5-year survival
- ER-/PR-/HER2+ Overall survival → 79%
- ER-/PR-/HER2+ Breast cancer-specific survival → 86%
5-year progression-free survival with neoadjuvant treatment overall
- ER-/PR-/HER2+ Neoadjuvant chemotherapy plus Herceptin → 83%
5-year progression-free survival with or without residual disease
- ER-/PR-/HER2+ RCB-I after neoadjuvant treatment → 88% to 96%
- ER-/PR-/HER2+ RCB-II after neoadjuvant treatment → 60%
- ER-/PR-/HER2+ RCB-III after neoadjuvant treatment → 45%

Mixed hormone receptor status

5-year survival: ER+/PR-
- ER+/PR-/HER2+ Overall survival → 81%
- ER+/PR-/HER2+ Breast cancer-specific survival → 88%
5-year survival: ER-/PR+
- ER-/PR+/HER2+ Overall survival → 79%
- ER-/PR+/HER2+ Breast cancer-specific survival → 85%

HER2+ where hormone receptor status was not specified

5-year progression-free survival with and without Herceptin
- HER2+ Standard of care treatment, 12 months Herceptin → 94%
- HER2+ Standard of care treatment, less than 12 months Herceptin → 80% to 87%
- HER2+ PCR after neoadjuvant chemotherapy, no Herceptin → 68%
- HER2+ At least one positive lymph node, neoadjuvant chemotherapy plus Herceptin plus radical mastectomy → 82%
8-year progression-free survival with adjuvant treatment
- HER2+ Adjuvant chemotherapy + concurrent Herceptin → 82% eight-year recurrence-free survival
- HER2+ Adjuvant chemotherapy followed by Herceptin → 79% eight-year recurrence-free survival

Below are links to recent studies concerning this topic. Please also see our article on HER2+ breast cancer prognosis, which describes factors that drive outcomes in this type of breast cancer.

Selected breast cancer studies

Risk of Subsequent Breast Cancer in Women with Early Stage HER2-Positive Breast Cancer in a Large Community Health Plan Cite
Haque R, Chen LH, Oestreicher N, Lalla D, Chlebowski RT. Risk of Subsequent Breast Cancer in Women with Early Stage HER2-Positive Breast Cancer in a Large Community Health Plan. Breast Cancer: Targets and Therapy. Informa UK Limited; 2023; Volume 15:637-645 10.2147/bctt.s420061
Outcomes of patients with small and node-negative HER2-positive early breast cancer treated with adjuvant chemotherapy and anti-HER2 therapy—a sub-analysis of the ALTTO study Cite
Nader-Marta G, Debien V, Eiger D, Tsourti Z, Caparica R, Kassapian M, et al. Outcomes of patients with small and node-negative HER2-positive early breast cancer treated with adjuvant chemotherapy and anti-HER2 therapy—a sub-analysis of the ALTTO study. British Journal of Cancer. Springer Science and Business Media LLC; 2022; 127:1799-1807 10.1038/s41416-022-01963-8
Long-term treatment patterns and survival in metastatic breast cancer by intrinsic subtypes – an observational cohort study in Sweden Cite
Lindman H, Wiklund F, Andersen KK. Long-term treatment patterns and survival in metastatic breast cancer by intrinsic subtypes – an observational cohort study in Sweden. BMC Cancer. Springer Science and Business Media LLC; 2022; 22 10.1186/s12885-022-10098-1
Long-Term Survival Outcomes of Patients with Small (≤1 cm) Node-Negative HER2-Positive Breast Cancer Not Treated with Adjuvant Anti-HER2-Targeted Therapy: A 10-Year Follow-Up Study Cite
Liikanen JS, Leidenius M, Joensuu H, Meretoja TJ. Long-Term Survival Outcomes of Patients with Small (≤1 cm) Node-Negative HER2-Positive Breast Cancer Not Treated with Adjuvant Anti-HER2-Targeted Therapy: A 10-Year Follow-Up Study. Breast Care. S. Karger AG; 2022; 17:279-287 10.1159/000520793
Breast cancer-specific mortality in early breast cancer as defined by high-risk clinical and pathologic characteristics Cite
Nelson DR, Brown J, Morikawa A, Method M. Breast cancer-specific mortality in early breast cancer as defined by high-risk clinical and pathologic characteristics. PLOS ONE. Public Library of Science (PLoS); 2022; 17:e0264637 10.1371/journal.pone.0264637
Abstract P3-18-03: Long-term outcomes for breast conservation plus radiotherapy versus mastectomy in early breast cancer after neoadjuvant systemic therapy: Results from the Swedish national breast cancer register (NKBC) Cite
Wang K, Duinmeijer A, Matikas A, Altena R, Johansson H, Fredholm H, et al. Abstract P3-18-03: Long-term outcomes for breast conservation plus radiotherapy versus mastectomy in early breast cancer after neoadjuvant systemic therapy: Results from the Swedish national breast cancer register (NKBC). Cancer Research. American Association for Cancer Research (AACR); 2022; 82:P3-18-03-P3-18-03 10.1158/1538-7445.sabcs21-p3-18-03
The impact of hormone receptor on the clinical outcomes of HER2-positive breast cancer: a population-based study Cite
Han Y, Wu Y, Xu H, Wang J, Xu B. The impact of hormone receptor on the clinical outcomes of HER2-positive breast cancer: a population-based study. International Journal of Clinical Oncology. Springer Science and Business Media LLC; 2022; 10.1007/s10147-022-02115-x
Adjuvant Trastuzumab Without Chemotherapy For Treating Early HER2-Positive Breast Cancer In Older Patients: A Cohort Study Accompanying With The RESPECT Trial Cite
Sawaki M, Taira N, Uemura Y, Saito T, Baba S, Kobayashi K, et al. Adjuvant Trastuzumab Without Chemotherapy For Treating Early HER2-Positive Breast Cancer In Older Patients: A Cohort Study Accompanying With The RESPECT Trial. Research Square Platform LLC; 2021; 10.21203/rs.3.rs-766187/v1
Concurrent versus sequential use of trastuzumab and chemotherapy in early HER2+ breast cancer Cite
Dackus GMHE, Jóźwiak K, van der Wall E, van Diest PJ, Hauptmann M, Siesling S, et al. Concurrent versus sequential use of trastuzumab and chemotherapy in early HER2+ breast cancer. Breast Cancer Research and Treatment. Springer Science and Business Media LLC; 2020; 10.1007/s10549-020-05978-8
Effect of level of hormone-receptor expression on treatment outcomes of “triple-positive” early-stage breast cancer Cite
Abdel-Razeq H, Edaily S, Iweir S, Salam M, Saleh Y, Sughayer M, et al. Effect of level of hormone-receptor expression on treatment outcomes of “triple-positive” early-stage breast cancer. Breast Cancer Research and Treatment. Springer Science and Business Media LLC; 2020; 10.1007/s10549-020-05942-6
Prognostic value of the Residual Cancer Burden index according to breast cancer subtype: Validation on a cohort of BC patients treated by neoadjuvant chemotherapy Cite
Hamy A, Darrigues L, Laas E, De Croze D, Topciu L, Lam G, et al. Prognostic value of the Residual Cancer Burden index according to breast cancer subtype: Validation on a cohort of BC patients treated by neoadjuvant chemotherapy. PLOS ONE. Public Library of Science (PLoS); 2020; 15:e0234191 10.1371/journal.pone.0234191
Risk factors of ipsilateral breast tumor recurrence in triple-negative or HER2-positive breast cancer patients who achieved pathological complete response after neoadjuvant chemotherapy. Cite
Tazo M, Kojima Y, Yoshida A, Nakayama S, Tokui R, Ogawa T, et al. Risk factors of ipsilateral breast tumor recurrence in triple-negative or HER2-positive breast cancer patients who achieved pathological complete response after neoadjuvant chemotherapy.. Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO); 2020; 38:e12599-e12599 10.1200/jco.2020.38.15_suppl.e12599
Impact of Stopping Trastuzumab in Early Breast Cancer: A Population-Based Study in Ontario, Canada Cite
Rushton M, Lima I, Tuna M, Johnson C, Ivars J, Pritchard K, et al. Impact of Stopping Trastuzumab in Early Breast Cancer: A Population-Based Study in Ontario, Canada. JNCI: Journal of the National Cancer Institute. Oxford University Press (OUP); 2020; 112:1222-1230 10.1093/jnci/djaa054
Pathologic Complete Response after Neoadjuvant Chemotherapy and Impact on Breast Cancer Recurrence and Survival: A Comprehensive Meta-analysis Cite
Spring LM, Fell G, Arfe A, Sharma C, Greenup R, Reynolds KL, et al. Pathologic Complete Response after Neoadjuvant Chemotherapy and Impact on Breast Cancer Recurrence and Survival: A Comprehensive Meta-analysis. Clinical Cancer Research. American Association for Cancer Research (AACR); 2020; 26:2838-2848 10.1158/1078-0432.ccr-19-3492
Abstract GS5-01: Residual cancer burden after neoadjuvant therapy and long-term survival outcomes in breast cancer: A multi-center pooled analysis Cite
Yau C, van der Noordaa M, Wei J, Osdoit M, Reyal F, Hamy A, et al. Abstract GS5-01: Residual cancer burden after neoadjuvant therapy and long-term survival outcomes in breast cancer: A multi-center pooled analysis. General Session Abstracts. American Association for Cancer Research; 2020; 10.1158/1538-7445.sabcs19-gs5-01
Outcomes for Patients with Residual Stage II/III Breast Cancer Following Neoadjuvant Chemotherapy (AFT-01) Cite
Stankowski-Drengler TJ, Schumacher JR, Hanlon B, Livingston-Rosanoff D, Van de Walle K, Greenberg CC, et al. Outcomes for Patients with Residual Stage II/III Breast Cancer Following Neoadjuvant Chemotherapy (AFT-01). Annals of Surgical Oncology. Springer Science and Business Media LLC; 2020; 27:637-644 10.1245/s10434-019-07846-2
Incidence of Late Relapses in Patients With HER2-Positive Breast Cancer Receiving Adjuvant Trastuzumab: Combined Analysis of NCCTG N9831 (Alliance) and NRG Oncology/NSABP B-31 Cite
Chumsri S, Li Z, Serie DJ, Mashadi-Hossein A, Colon-Otero G, Song N, et al. Incidence of Late Relapses in Patients With HER2-Positive Breast Cancer Receiving Adjuvant Trastuzumab: Combined Analysis of NCCTG N9831 (Alliance) and NRG Oncology/NSABP B-31. Journal of Clinical Oncology. American Society of Clinical Oncology (ASCO); 2019; 37:3425-3435 10.1200/jco.19.00443
Treatment patterns and survival in HER2-positive early breast cancer: a whole-of-population Australian cohort study (2007–2016) Cite
Tang M, Schaffer A, Kiely BE, Daniels B, Simes RJ, Lee CK, et al. Treatment patterns and survival in HER2-positive early breast cancer: a whole-of-population Australian cohort study (2007–2016). British Journal of Cancer. Springer Science and Business Media LLC; 2019; 121:904-911 10.1038/s41416-019-0612-5
Revisit the risk factors of recurrence in node involved HER2-positive breast cancer Cite
Hasegawa Y, Kogawa T, Shimokawa M, Kusuhara S, Fujimoto Y, Harano K, et al. Revisit the risk factors of recurrence in node involved HER2-positive breast cancer. Annals of Oncology. Elsevier BV; 2019; 30:vi114 10.1093/annonc/mdz338.102

Definition of recurrence & survival terms

HER2+ breast cancer recurrence & survival data

Selected breast cancer studies

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