Discordance of Estrogen &amp; Progesterone Receptors After Neoadjuvant Chemotherapy in Breast Cancer- an Indian Study

Anand, Aravindh Sivanandan; Velayudhan, Sandeep Thekoot

doi:10.1007/s13193-016-0515-3

Cited by 7 publications

(3 citation statements)

References 12 publications

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“…Certain reports suggest that poor survival in discordant cases may be related to the inappropriate use of targeted therapies; 12 an Indian study has also suggested that ER/PR status may change after chemotherapy and that re-evaluation is needed after chemotherapy. 17 In a study, all anti-estrogen-treated tumors lost ER expression, particularly in cases involving brain metastases. 18 In this study, we demonstrated for the first time that adjuvant endocrine therapy and chemotherapy may alter PR and ER receptor profiles.…”

Section: Discussionmentioning

confidence: 98%

<p>The Prognostic Impact of Hormonal Receptor and HER-2 Expression Discordance in Metastatic Breast Cancer Patients</p>

Yang¹,

Li²,

Li³

et al. 2020

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These authors contributed equally to this work Background: Hormone receptor (HR) and human epidermal growth factor receptor (HER2) discordance between primary and metastatic breast cancer lesions is common. However, its impact on long-term survival remains unclear. We aimed to determine the prognostic value of this discordance in patients with metastaticf breast cancer (MBC). Methods: A total of 270 patients with MBC who were underwent re-biopsy of progressive metastases at Zhejiang Cancer Hospital from January 1, 2012 to December 31, 2015 with patients consent and then review their primary tumors pathological findings. The HR and HER2 status in both primary and progressive metastatic lesions was determined by immunohistochemistry and/or fluorescence in situ hybridization. The discordance rates were correlated with the clinicopathologic characteristics, metastatic lesions, salvage treatment, and survival analysis in this population. Results: A total of 142 (52.6%) MBC patients were diagnosed with discordant HR and HER2 status. Alterations in estrogen receptor (ER), progesterone receptor (PR), and HER2 status were observed in 20.70%, 37.78%, and 11.48% cases, respectively. Chemotherapy (P=0.0192) and endocrine therapy (P=0.048) significantly affected the conversion of HR status. Endocrine therapy was positively correlated with PR discordance (P=0.002), while ER discordance was associated with adjuvant chemotherapy (P=0.031). Survival analysis showed that ER status alterations between primary and metastatic lesions were associated with overall survival (P=0.002). The clinical prognosis was significantly worse with HR losses than with persistent HR positivity (P=0.023). In Cox multivariate analysis, the loss of HR expression and conversion to triple negative were independent prognostic indicators. Conclusion: Discordance in HR status between primary and metastatic lesions may impact the prognosis of MBC, and HR conversion has independent prognostic value.

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Section: Discussionmentioning

confidence: 98%

<p>The Prognostic Impact of Hormonal Receptor and HER-2 Expression Discordance in Metastatic Breast Cancer Patients</p>

Yang¹,

Li²,

Li³

et al. 2020

OTT

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“…Researchers have hypothesized that the diversity in prognosis may be due to differences in the biological characteristics of the primary tumor and the recurrent or metastatic tumors [ 8 , 9 ]. The expression levels of the estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), and Ki-67 biomarker have been proven to be associated with the prognoses of breast cancer [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

Discordance in ER, PR, HER2, and Ki-67 Expression Between Primary and Recurrent/Metastatic Lesions in Patients with Primary Early Stage Breast Cancer and the Clinical Significance: Retrospective Analysis of 75 Cases

Zhang

Zhao

et al. 2021

Pathol. Oncol. Res.

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Background: The objective was to explore the discordance in the expression of the estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 between primary and recurrent/metastatic lesions in patients with early stage breast cancer as well as the prognostic impact.Method: Patients with early-stage primary breast cancer and confirmed recurrence/metastasis at Peking Union Medical College Hospital between January 2005 and August 2018 were screened. The details of discordance in each parameter between primary and recurrent/metastatic lesions and progression were recorded. Regression and survival analysis were applied to determine the association and clinical impact of the discordance.Results: We evaluated 75 patients. The discordance rate of ER, PR, HER2, and Ki-67 expression was 9.3, 14.7, 14.7, and 21.5%, respectively. Additionally, 66.7, 11.8, 14.3, and 0% of patients with Luminal A, Luminal B, HER2, and triple-negative primary tumors presented with a different subtype for the recurrent/metastatic tumors, respectively. No statistical difference in progression-free survival was observed according to the subtype of the recurrent or metastatic breast cancer (p > 0.05). Among 69 patients for whom treatment was adjusted after recurrence or metastasis, 66 patients remained recurrence-free during the follow-up period.Conclusion: For patients with early-stage breast cancer, the ER, PR, HER2, and Ki-67 expression profile for recurrent/metastatic tumors does not always match that of the primary tumor. After adjusting treatment according to the receptor expression in recurrent/metastatic lesions, most patients remained progression-free during the follow-up period.

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“…Dear Sir, We read with interest the article by Anand et al [1], Discordance of estrogen and progesterone receptors after neoadjuvant chemotherapy in breast cancer: an Indian study, recently published in the Indian Journal of Surgical Oncology (September 2016, 7 (3): 316-319DOI 10.1007/s13193-016-0515-3). The authors retrospectively evaluated the changes in estrogen (ER) and progesterone receptor (PR) immunohistochemistry (IHC), measured before and after neoadjuvant chemotherapy (NACT) for breast cancer, and also analysed the relationship between hormone receptor expression and tumour response to primary systemic chemotherapy.…”

mentioning

confidence: 99%

Discordance in Immunohistochemical Status of Breast Cancer Post Neoadjuvant Chemotherapy

Agrawal

Chatterjee

Arun

et al. 2016

Indian J Surg Oncol

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Discordance of Estrogen & Progesterone Receptors After Neoadjuvant Chemotherapy in Breast Cancer- an Indian Study

Cited by 7 publications

References 12 publications

<p>The Prognostic Impact of Hormonal Receptor and HER-2 Expression Discordance in Metastatic Breast Cancer Patients</p>

<p>The Prognostic Impact of Hormonal Receptor and HER-2 Expression Discordance in Metastatic Breast Cancer Patients</p>

Discordance in ER, PR, HER2, and Ki-67 Expression Between Primary and Recurrent/Metastatic Lesions in Patients with Primary Early Stage Breast Cancer and the Clinical Significance: Retrospective Analysis of 75 Cases

Discordance in Immunohistochemical Status of Breast Cancer Post Neoadjuvant Chemotherapy

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