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Clinical Studies

Comment on “Pathological complete response, category change, and prognostic significance of HER2-low breast cancer receiving neoadjuvant treatment: a multicenter analysis of 2489 cases”

British Journal of Cancer volume 130, pages 893–894 (2024)Cite this article

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We read with interest the original paper by Zhu et al. [1], in which they analyzed 2489 breast cancers patients undergoing neoadjuvant therapy (NAT) from 2009 to 2020. Human epidermal growth factor receptor-2 (HER2)-low status, defined as immunohistochemical (IHC) expression 1+/2+ and fluorescence in situ hybridization (FISH) negative, was observed in 41.1% of patients. HER2-low patients had higher estrogen receptor (ER) positivity and similar pathological complete response rates compared to HER2-0 patients. However, HER2 status showed low concordance rates. HER2-low patients had better prognosis, especially in ER-positive subset, suggesting the need for re-testing HER2 status post-NAT in the era of anti-HER2 antibody-drug conjugates. We highly appreciate the authors’ efforts. Nonetheless, we would like to present our concern about the authors’ work when they used Cohen’s Kappa statistic to estimate concordance rates of HER2 and other biomarkers.

Assessing concordance rate is crucial in research. Kappa statistics serve as essential tools, ensuring consistent ratings among assessors [2]. They quantitatively measure agreement levels, especially important in studies involving categorical data. Categorical data entails distinct value variables, either ordered or unordered. Ordinal variables, like Likert scale responses, possess a clear hierarchy [3], whereas nominal variables, such as colors or gender identities, treat categories equally [4].

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Funding

This work was supported by the Fundamental Research Funds in Heilongjiang Provincial Universities (145109136).

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Authors and Affiliations

  1. Department of Biotechnology, College of Life Science and Agriculture Forestry, Qiqihar University, Qiqihar, 161006, China

    Tianfei Yu & Changfei Yang

  2. Department of Computer Science and Technology, College of Computer and Control Engineering, Qiqihar University, Qiqihar, 161006, China

    Ming Li

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  1. Tianfei Yu
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  2. Changfei Yang
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Contributions

TY: conceived and prepared the first draft of the manuscript; CY: analyzed and interpreted the data; ML: critically reviewed the draft. All authors read and approved the final manuscript.

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Correspondence to Tianfei Yu or Ming Li.

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Yu, T., Yang, C. & Li, M. Comment on “Pathological complete response, category change, and prognostic significance of HER2-low breast cancer receiving neoadjuvant treatment: a multicenter analysis of 2489 cases”. Br J Cancer 130, 893–894 (2024). https://doi.org/10.1038/s41416-024-02616-8

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