That is a really good question. It seems it's possible to change Her2 status after neoadjuvant therapy.
Change in HER2 status after neoadjuvant chemotherapy and the prognostic impact in patients with primary breast cancer
Abstract
Background:
We aimed to assess change in HER2 status after neoadjuvant
chemotherapy (NAC) in patients with primary breast cancer and the
prognostic impact of such changes.
Patients and methods:
The study comprised 588 patients with a non-pathologic complete
response who received anthracycline and/or taxane-based regimens in NAC
setting. HER2 status was assessed before NAC and in residual invasive
tumor of the surgical specimens. The associations between the change in
HER2 status and clinicopathological factors were assessed.
Results:
Before NAC, 489 (83%) of the 588 patients had HER2-negative tumors
and 99 patients (17%) had HER2-positive tumors. Eleven (2.2%) of the
HER2-negative tumors changed to HER2-positive, while 33 (33%) of the
HER2-positive tumors changed to HER2-negative. ER and PR-positivity
before NAC were associated with loss of HER2-positivity, whereas
receiving trastuzumab was not. In terms of disease-free survival, there
was no difference between patients with and those without change in HER2
status after NAC in either the patients with HER2-negative tumors (P =
0.26) or with HER2-positive tumors before NAC (P = 0.23).
Conclusion:
Our results showed that changes in HER2 status did not affect
patients' prognosis. Further studies are needed to determine whether
HER2-targeting agents can be omitted when loss of HER2-positivity is
confirmed after NAC.
https://pubmed.ncbi.nlm.nih.gov/28767137/