Analysis of the concordance rates between core needle biopsy and surgical excision in patients with breast cancer

Ricci, Marcos Desídérío; Filho, Carlos Marino Cabral Calvano; Filho, Helio Rubens de Oliveira; Filassi, José Roberto; Pinotti, José Aristodemo; Baracat, Edmund Chada

doi:10.1590/s0104-42302012000500008

Cited by 22 publications

(16 citation statements)

References 27 publications

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“…A 23% reduction in the mean Ki-67 proliferative index was observed in the post-treatment tumor (Mean +/– SEM: 10% +/– 1.0) compared to the pre-treatment tumor (Mean +/– SEM: 13% +/– 0.5) ( p = 0.02) (Figure 3B). Given that substantial concordance has been reported for the Ki-67 index between breast cancer core needle biopsies and their respective final surgical specimen [37], we believe this propranolol-mediated statistically significant decrease in tumor proliferation is valid.…”

Section: Resultssupporting

confidence: 57%

Use of non-selective β-blockers is associated with decreased tumor proliferative indices in early stage breast cancer

et al. 2016

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Previous studies suggest beta-adrenergic receptor (β-AR) antagonists (β-blockers) decrease breast cancer progression, tumor metastasis, and patient mortality; however the mechanism for this is unknown. Immunohistochemical analysis of normal and malignant breast tissue revealed overexpression of β1-AR and β3-AR in breast cancer. A retrospective cross-sectional study of 404 breast cancer patients was performed to determine the effect of β-blocker usage on tumor proliferation. Our analysis revealed that non-selective β-blockers, but not selective β-blockers, reduced tumor proliferation by 66% (p < 0.0001) in early stage breast cancer compared to non-users. We tested the efficacy of propranolol on an early stage breast cancer patient, and quantified the tumor proliferative index before and after treatment, revealing a propranolol-mediated 23% reduction (p = 0.02) in Ki67 positive tumor cells over a three-week period. The anti-proliferative effects of β-blockers were measured in a panel of breast cancer lines, demonstrating that mammary epithelial cells were resistant to propranolol, and that most breast cancer cell lines displayed dose dependent viability decreases following treatment. Selective β-blockers alone or in combination were not as effective as propranolol at reducing breast cancer cell proliferation. Molecular analysis revealed that propranolol treatment of the SK-BR-3 breast cancer line, which showed high sensitivity to beta blockade, led to a reduction in Ki67 protein expression, decreased phosphorylation of the mitogenic signaling regulators p44/42 MAPK, p38 MAPK, JNK, and CREB, increased phosphorylation of the cell survival/apoptosis regulators AKT, p53, and GSK3β. In conclusion, use of non-selective β-blockers in patients with early stage breast cancer may lead to decreased tumor proliferation.

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Section: Resultssupporting

confidence: 57%

Use of non-selective β-blockers is associated with decreased tumor proliferative indices in early stage breast cancer

et al. 2016

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“…Identifying HER2-positive breast cancer patients by CNB is important, as neoadjuvant HER2-targeted therapy is an effective option for these patients. In this study, the CR for HER2 status, as determined by HER2 IHC or reflex HER2 SISH, was as high as 99.7% (kappa, 0.988), which was higher than most previous reports (ranging from 61%-97.3%) [10,[18][19][20][21][22][23][24][25][26][27][28][29]. The reason for this high CR could partially be due to performing reflex HER2 SISH for all HER2 IHC equivocal cases to determine final HER2 status strictly following ASCO/CAP guidelines.…”

Section: Discussioncontrasting

confidence: 57%

Analysis of the molecular subtypes of preoperative core needle biopsy and surgical specimens in invasive breast cancer

Jeong

Kang

Lee

et al. 2020

J Pathol Transl Med

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Background: Accurate molecular classification of breast core needle biopsy (CNB) tissue is important for determining neoadjuvant systemic therapies for invasive breast cancer. The researchers aimed to evaluate the concordance rate (CR) of molecular subtypes between CNBs and surgical specimens. Methods: This study was conducted with invasive breast cancer patients who underwent surgery after CNB at Seoul St. Mary's Hospital between December 2014 and December 2017. Estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki67 were analyzed using immunohistochemistry. ER and PR were evaluated by Allred score (0-8). HER2 was graded from 0 to +3, and all 2+ cases were reflex tested with silver in situ hybridization. The labeling index of Ki67 was counted by either manual scoring or digital image analysis. Molecular subtypes were classified using the above surrogate markers. Results: In total, 629 patients were evaluated. The CRs of ER, PR, HER2, and Ki67 were 96.5% (kappa, 0.883; p < .001), 93.0% (kappa, 0.824; p < .001), 99.7% (kappa, 0.988; p < .001), and 78.7% (kappa, 0.577; p < .001), respectively. Digital image analysis of Ki67 in CNB showed better concordance with Ki67 in surgical specimens (CR, 82.3%; kappa, 0.639 for digital image analysis vs. CR, 76.2%; kappa, 0.534 for manual counting). The CRs of luminal A, luminal B, HER2, and triple negative types were 89.0%, 70.0%, 82.9%, and 77.2%, respectively. Conclusions: CNB was reasonably accurate for determining ER, PR, HER2, Ki67, and molecular subtypes. Using digital image analysis for Ki67 in CNB produced more accurate molecular classifications.

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“…29 Purdie et al reported that absent PgR expression was significantly associated with poorer prognosis, even within ER-positive cases. 30 These reports suggests that the assessment of PgR expression in breast carcinomas may still benefit from patient's prognosis. However, it should be noted that most of the treatment response data in previous reports relate to surgical specimens.…”

Section: Discussionmentioning

confidence: 99%

“…19 However, the reliability of using CNB specimens for detailed assessment is in doubt because of the relatively small number of cases and differing results between previous studies (Table 1). [20][21][22][23][24][25][26][27][28][29][30][31][32][33] The purpose of this study was to compare the ER, PgR, HER2 status, and Ki-67 index by IHC analysis in breast carcinoma to determine the level of concordance between CNB and surgical specimens.…”

mentioning

confidence: 99%

The Reliability of Core-Needle Biopsy in Assessment of Hormone Receptor, HER2, and Ki-67 in Breast Carcinoma

Ueno

Kuroda

Abe

et al. 2017

International Surgery

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The purpose of this study was to compare the estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2) status and Ki-67 index by immunohistochemical (IHC) analysis in breast carcinoma to determine the level of concordance between core-needle biopsy (CNB) and surgical specimens. Summary of Background: Accurate preoperative diagnosis of a breast lesion has recently been considered essential to the treatment strategy to achieve optimal treatment without delay. However, the reliability of using CNB specimens for IHC assessment is in relatively small number of cases and differing results between previous studies. Methods: The patients included in this study were 255 patients with primary breast carcinoma who had CNB and subsequent surgical resection at the Hospital of Dokkyo Medical University between 2010 and 2016. We compare the ER, PgR, HER2 status, and Ki-67 index by IHC analysis in breast carcinoma between CNB and surgical specimens. Results: There was a concordance rate between the ER, PgR, HER2, and Ki-67 IHC assessment of CNB and surgical specimens in 99.0%, 92.1%, 86.3%, and 91.5%, respectively. We also found small numbers of discordant cases in the estimation for which a discrepancy in determination led to a change in treatment.

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Analysis of the concordance rates between core needle biopsy and surgical excision in patients with breast cancer

Cited by 22 publications

References 27 publications

Use of non-selective β-blockers is associated with decreased tumor proliferative indices in early stage breast cancer

Use of non-selective β-blockers is associated with decreased tumor proliferative indices in early stage breast cancer

Analysis of the molecular subtypes of preoperative core needle biopsy and surgical specimens in invasive breast cancer

The Reliability of Core-Needle Biopsy in Assessment of Hormone Receptor, HER2, and Ki-67 in Breast Carcinoma

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