In this study, we compared the accuracy of marker evaluation in core needle biopsy (CNB) specimens versus excision specimens (ESs) from breast cancer patients. This retrospective study used data collected from the breast cancer database at the West China Hospital, China. Immunohistochemistry (IHC) results from CNB specimens and ESs were compared, using estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 as markers. Molecular subtyping and endocrine therapy usage correlations based on CNB samples and ESs were evaluated. The results obtained from CNB samples and ESs exhibited substantial agreement for the detection of ER (κ = 0.522), PR (κ = 0.441), and HER2 (κ = 0.451), and also influenced endocrine therapy usage. Fair and poor correlations were observed for Ki-67 staining and molecular subtyping (κ = 0.195), respectively. This disagreement might be attributable to a combination of heterogeneity and large tumor size. This study indicates that the discordance rate in molecular marker staining between CNB specimens and ESs is significant enough that results obtained with CNB specimens should be used cautiously or verified using ESs.
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Breast cancer is one of the most common malignant tumors in woman. Ovarian and pelvic metastasis in breast cancer are very rare, and the prognosis is often poor. Lacking typical clinical manifestation, misdiagnose is common. We report a case about a middle-aged postmenopausal woman with complaints of finding a left breast mass and irregular vaginal bleeding. Through ultrasound-guided coreneedle biopsy of the masses, the patient's final diagnosis was breast cancer with ovarian and pelvic metastasis.The patient received combinations of chemotherapy (intravenous infusion or peritoneal perfusion), radical surgery (gynecological operation and modified radical mastectomy), radiation and endocrine therapy. Fortyeight months follow-up showed that the patient is generally in good condition and had no signs of local recurrence or metastasis. Invasive ductal carcinoma (IDC) of the breast with unilateral ovarian and pelvic metastasis is rare. It is not easy to differentiate from primary ovarian malignant tumor, and the prognosis is generally poor. We chose a combination chemotherapy regimen sensitive to both breast and ovarian tumors for the patient. The therapeutic effect is remarkable. Only a small number of tumor cells were found in pelvic and ovarian tumors. The patient's breast tumors reached pathological complete remission (pCR), which might be the reason for the patient's good prognosis.
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