Concordance between core needle biopsy and surgical excision for breast cancer tumor grade and biomarkers

Shanmugalingam, Aswin; Hitos, Kerry; Hegde, Shrenik; Al-Mashat, Ali; Pathmanathan, Nirmala; Edirimmane, Senarath; Hughes, Timothy M.; Ngui, Nicholas K.

doi:10.1007/s10549-022-06548-w

Cited by 14 publications

(7 citation statements)

References 30 publications

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“…Previous studies have shown CNB to be almost as accurate as open excisional biopsy in diagnosing breast disease [16], and to have an excellent agreement between diagnosis made by examination of CNB and surgical specimens [17,18]. This concordance is also observed in the context of histopathological biomarkers such as ER, PR and HER2, indicating that retesting for surgical excision may not be necessary [19,20]. All this means that CNB is well established as an important diagnostic tool in diagnosing breast cancer and it is now considered the initial method of choice for diagnosing breast disease [15,16,18,[21][22][23][24].…”

Section: Introductionmentioning

confidence: 65%

Breast carcinoma grading on core needle biopsy – to grade or not to grade?

Szpor,

Witczak,

Storman

et al. 2023

pjp

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Core needle biopsy (CNB) is well established as an important diagnostic tool in diagnosing breast cancer and it is now considered the initial method of choice for diagnosing breast disease and the basis for the treatment planning. The concordance rate between CNB and surgical excision specimen in determination of histological grade (HG) varies widely across literature, ranging from 59-91%. The aim of our study was to investigate the level of concordance between CNB and surgical excision specimen for the determination of HG for breast cancer patients. The study population included 157 women with a breast tumor who underwent a core needle biopsy for breast carcinoma and a subsequent surgical excision of the tumor. The concordance level between core needle biopsy and surgical resection specimen for overall histologic grading was 73%: for tubule formation -71%, for nuclear pleomorphism -91%, for the mitotic index -59%. Our study shows that our institution's histologic grading of CNBs and surgical excisions shows a fairly good correlation and is useful for the planning of treatment.

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Section: Introductionmentioning

confidence: 65%

Breast carcinoma grading on core needle biopsy – to grade or not to grade?

Szpor,

Witczak,

Storman

et al. 2023

pjp

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“…Core needle biopsy (CNB) is less invasive and more cost-effective than excisional biopsy, and it is currently recommended as the first-line diagnostic modality [ 7 ]. Many studies have explored the reliability of biomarker testing using CNB compared with ground-truth surgical biomarker results and have reported favorable outcomes [ 8 – 10 ]. Although evaluation of HER2 status using CNB was considered reliable, such results were based on a binary classification system, which distinguishes HER2-positive from HER2-negative tumors [ 11 – 13 ].…”

Section: Introductionmentioning

confidence: 99%

Concordance of HER2 status between core needle biopsy and surgical resection specimens of breast cancer: an analysis focusing on the HER2-low status

Na,

Kim,

Park

et al. 2024

Breast Cancer

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Background Human epidermal growth factor receptor 2 (HER2)-low status has recently gained attention because of the potential therapeutic benefits of antibody–drug conjugates (ADCs) in breast cancer patients. We aimed to investigate the concordance of HER2 status between core needle biopsy (CNB) and subsequent surgical resection specimens focusing on the HER2-low status. Methods This retrospective study was conducted in 1,387 patients with invasive breast cancer whose HER2 status was evaluated in both CNB and surgical resection specimens. The discordance rates between CNB and surgical resection specimens and the clinicopathological features associated with HER2 status discordance were analyzed. Results The overall concordance rates of HER2 status between CNB and surgical resection specimens were 99.0% (κ = 0.925) for two-group classification (negative vs. positive) and 78.5% (κ = 0.587) for three-group classification (zero vs. low vs. positive). The largest discordance occurred in CNB-HER2-zero cases with 42.8% of them reclassified as HER2-low in surgical resection. HER2 discordance was associated with lower histologic grade, tumor multiplicity, and luminal A subtype. In multivariate analysis, tumor multiplicity and estrogen receptor (ER) positivity were independent predictive factors for HER2-zero to low conversion. Conclusions Incorporation of HER2-low category in HER2 status interpretation reduces the concordance rate between CNB and surgical resection specimens. Tumor multiplicity and ER positivity are predictive factors for conversion from HER2-zero to HER2-low status. Therefore, HER2 status should be re-evaluated in resection specimens when considering ADCs in tumors exhibiting multiplicity and ER positivity.

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“…In addition, technical and preanalytical factors may also affect the accuracy of HER2 testing. In clinical practice, preoperative core needle biopsy (CNB) is the standard procedure for breast cancer diagnosis and neoadjuvant regimen decision [ 10 , 11 ] due to its high accuracy similar to that of surgical excision specimen (SES) samples in histology and estrogen receptor (ER), progesterone receptor (PR) and HER2 status determination [ 12 , 13 ]. Nevertheless, owing to the relatively small sample size and tumor heterogeneity, there is inevitable discordance in biomarker assessment between CNB and SES samples.…”

Section: Introductionmentioning

confidence: 99%

HER2-Low Status Is Not Accurate in Breast Cancer Core Needle Biopsy Samples: An Analysis of 5610 Consecutive Patients

Zhu

Tong

et al. 2022

Cancers

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Background: HER2-Low status is found in approximately half of breast cancer patients and shows potential benefits from novel antibody–drug conjugates (ADCs). Data on the accuracy of HER2-Low status between core needle biopsy (CNB) and surgical excision specimen (SES) samples are lacking. We aimed to investigate the accuracy of HER2-Low status diagnosis between CNB and SES samples. Methods: Consecutive early-stage breast cancer patients who underwent surgery from January 2009 to March 2022 with paired CNB and SES samples were retrospectively reviewed. HER2-Low was defined as IHC 1+ or IHC2+ and FISH-negative. Concordance rates were analyzed by the Kappa test. Further clinicopathological characteristics were compared among different HER2 status and their changes. Results: A total of 5610 patients were included, of whom 3209 (57.2%) and 3320 (59.2%) had HER2-Low status in CNB and SES samples, respectively. The concordance rate of HER2 status in the whole population was 82.37% (Kappa = 0.684, p < 0.001), and was 76.87% in the HER2-Negative patients (Kappa = 0.372, p < 0.001). Among 1066 HER2-0 cases by CNB, 530 patients were classified as HER2-Low tumors. On the contrary, in 3209 patients with HER2-Low tumor by CNB, 387 were scored as HER2-0 on the SES samples. ER-negative or Ki67 high expression tumor by CNB had a high concordance rate of HER2-Low status. Conclusions: A relatively low concordance rate was found when evaluating HER2-Low status between CNB and SES samples in HER2-Negative breast cancer patients, indicating the necessity of retesting HER2 low status at surgery, which may guide further therapy in the era of anti-HER2 ADCs.

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Concordance between core needle biopsy and surgical excision for breast cancer tumor grade and biomarkers

Cited by 14 publications

References 30 publications

Breast carcinoma grading on core needle biopsy – to grade or not to grade?

Breast carcinoma grading on core needle biopsy – to grade or not to grade?

Concordance of HER2 status between core needle biopsy and surgical resection specimens of breast cancer: an analysis focusing on the HER2-low status

HER2-Low Status Is Not Accurate in Breast Cancer Core Needle Biopsy Samples: An Analysis of 5610 Consecutive Patients

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