Impact of host and histopathological factors on the discrepancies in estrogen receptor, and progesterone receptor, and HER2 status between core needle biopsy and surgically excised tumors

Nakamura, Rikiya; Yamamoto, Nobuto; Shiina, Nobumitsu; Miyaki, Toshiko; Ikebe, Dai; Itami, Makiko; Sugiyama, Takashi; Miyazaki, Masaru

doi:10.1016/j.breast.2015.10.009

Cited by 9 publications

(14 citation statements)

References 21 publications

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“…Several studies reported varying concordance of results between the surgical specimen and core needle biopsy of ER (77.8 to 99%), PR (69 to 97%), and HER2 (64 to 97%), respectively, with particular emphasis placed on a general tendency for higher discrepancies in PR status [22][23][24][25][26][27]. In addition to substantial improvement in receptor measurement accuracy, interlaboratory variation still exists in the assignment of receptor status [28,29].…”

Section: Discussionmentioning

confidence: 99%

Estrogen, progesterone, and human epidermal growth factor receptor 2 discordance between primary and metastatic breast cancer

Walter

Fischer

Deutsch

et al. 2020

Breast Cancer Res Treat

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Background The estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) statuses are frequently discordant between the primary tumor and metastatic lesions in metastatic breast cancer. This can have important therapeutic implications. Patients and methods In all, 541 patients with available receptor statuses from both primary tumor and metastatic lesion treated at Heidelberg and Tuebingen University Hospitals between 1982 and 2018 were included. Results Statistically significant discordance rates of 14% and 32% were found for ER and PR. HER2 status was statistically insignificantly discordant in 15% of patients. Gain in HER2 positivity was associated with an improved overall survival, whereas loss of HR positivity was associated with worse overall survival. Antiendocrine treatment differed in 20% of cases before and after biopsy and HER2-directed treatment in 14% of cases. Conclusions Receptor statuses are discordant between primary tumor and metastasis in a considerable fraction of patients with metastatic breast cancer. Next to a highly presumed predictive value with respect to efficacy of endocrine and HER2targeted therapy, discordance seems to provide prognostically relevant information. Where feasible, metastatic lesions should be biopsied in accordance with current guidelines.

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Section: Discussionmentioning

confidence: 99%

Estrogen, progesterone, and human epidermal growth factor receptor 2 discordance between primary and metastatic breast cancer

Walter

Fischer

Deutsch

et al. 2020

Breast Cancer Res Treat

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“…CNB is a routinely used method for preoperative assessment of breast cancer patients (1-3,5). CNB may not completely represent the biological profile of the tumor in all cases because of sampling errors (15), insufficient sample size of the CNB, fixation problems of RSs, intratumoral heterogeneity, and menopausal status of patients (3,5,8,9). The aim of this study was to assess the concordance of CNB and RS results and to clarify the reasons for discrepancies.…”

Section: Discussionmentioning

confidence: 99%

“…Diagnosis of breast carcinoma was reported to be concordant in 96% to 100% of cases in a previous study (11). Accuracy of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER-2) status has been found to range from 77.8% to 100% for ER, 69% to 97.1% for PR, and 60% to 98% for HER-2 in the literature (8). For Ki-67, the criteria for subclassification of breast carcinomas are yet to be defined, although a few suggestions of cutoffs have been made.…”

Section: Introductionmentioning

confidence: 99%

“…For cases with complete remission after neoadjuvant systemic therapy, CNB can be the only method that reflects the characteristics of the tumor (4)(5)(6). On the other hand, CNB is a useful tool for the diagnosis and management of sentinel lymph node metastasis (7) and distant metastasis (8). In addition to its diagnostic and predictive role in breast cancer, CNB is used to support patients' education, cooperation, and consent (9).…”

Section: Introductionmentioning

confidence: 99%

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Concordance of immunohistochemistry between core needle biopsy and surgical resection of breast cancer

Kombak¹,

Şahin²,

Hande³

et al. 2017

Turk J Med Sci

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Background/aim: The purpose of this study was to evaluate the concordance of immunohistochemical (IHC) parameters of breast lesions between the core needle biopsy (CNB) and the surgical resection specimen.Materials and methods: CNB and resection specimens of female patients were retrospectively analyzed. ER, PR, HER-2, and Ki-67 parameters were compared for each patient. A total of 284 cases were assessed. Forty-one and 48 cases were excluded from the HER-2 and Ki-67 examinations, respectively, because the CNBs did not allow for IHC.Results: Concordance rates were 93.3% for ER, 89.4% for PR, 90.1% for HER-2, and 80.9% for Ki-67. Conclusion:CNB is accurate for the evaluation of the surrogate molecular profile of invasive breast cancer despite the heterogeneity of tumors.

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“…Understanding the factors associated with the discordance between the features of syLNs and pBT may contribute to the adaptation of LN biopsy. We have reported that core needle biopsy (CNB) can accurately determine the biological characteristics 17 and add useful information regarding surgical treatment planning of AxLNs. 18 The syLNs biopsy can expand preoperative treatment options when the biological characteristics of syLNs and pBT are discordant.…”

Section: Introductionmentioning

confidence: 99%

Clinical impact of the biology of synchronous axillary lymph node metastases in primary breast cancer on preoperative treatment strategy

Nakamura

Hayama

Sonoda

et al. 2021

Journal of Surgical Oncology

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Background and objectives: The purpose of this study was to assess the utility of determining the biological features of synchronous axillary lymph node (syLN) metastasis of breast cancer in evaluating the efficacy of preoperative systemic chemotherapy (PST). Materials and Methods:The retrospective subjects initially comprised 59 patients (T1c-4 N1-3 M0) diagnosed with syLN metastasis via core needle biopsy who received PST. The hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) status in each patient was assessed in primary breast tumor (pBT) and syLNs using immunohistochemistry, and the patients were classified into HR(+), HER2(+), and triple negative breast cancer (TN) subtypes.Results: Subtype shift (SS) of pBT in syLNs was observed in 28% cases for HR(+), in 6% cases for the HER2(+), and in 16% cases for the TN. The pCR rate of the pBT and syLNs types were 45% and 36% in the HR(+), 45% and 39% in the TN, and 94% and 100% in the HER2(+), respectively. In SS cases, the pCR rate was significantly higher in 75% cases compared with 33% of the no-SS cases. Conclusion:A SS in syLNs was more frequent in HR(+) than in other types.

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Impact of host and histopathological factors on the discrepancies in estrogen receptor, and progesterone receptor, and HER2 status between core needle biopsy and surgically excised tumors

Cited by 9 publications

References 21 publications

Estrogen, progesterone, and human epidermal growth factor receptor 2 discordance between primary and metastatic breast cancer

Estrogen, progesterone, and human epidermal growth factor receptor 2 discordance between primary and metastatic breast cancer

Concordance of immunohistochemistry between core needle biopsy and surgical resection of breast cancer

Clinical impact of the biology of synchronous axillary lymph node metastases in primary breast cancer on preoperative treatment strategy

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