PURPOSE: To assess the concordance of breast cancer immunohistochemical receptor assays on core biopsy and surgical specimens. PATIENTS AND METHODS: We identified 100 patients whose core biopsy and definitive surgical specimens were processed in our hospital. New sections, with core and surgical specimens on the same slides, were stained for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER-2) immunohistochemistry (IHC). Two pathologists assessed the sections independently. Raw scores and clinically significant groupings were compared. RESULTS: Concordance for ER, PR, overall hormone receptor (HR), and HER-2 status was seen in 86%, 83%, 90%, and 80% of patients, respectively. The core was positive, while the surgical specimen was negative in 13%, 11%, 9%, and 1% of patients, respectively. Using a log-linear model, differences in ER, PR, and HER-2 staining were all in the direction of stronger staining in the cores, and were statistically significant. Nine percent (95% CI, 4.2% to 16.4%) of women in this group would have had endocrine therapy inappropriately withheld if management decisions were based on surgical specimen results alone. CONCLUSION: ER and PR assays on core biopsy specimens are more reliable than assays on surgical specimens. Receptor IHC should be performed on core biopsy specimens to avoid patients with HR positive cancers not receiving appropriate hormonal therapy and being overtreated with systemic chemotherapy. Biopsy should be considered in patients with "receptor negative" cancer and recurrent disease.
PURPOSE: To assess the concordance of breast cancer immunohistochemical receptor assays on core biopsy and surgical specimens. PATIENTS AND METHODS: We identified 100 patients whose core biopsy and definitive surgical specimens were processed in our hospital. New sections, with core and surgical specimens on the same slides, were stained for estrogen receptor (ER), progesterone receptor (PR), and humanepidermal growth factor receptor 2 (HER-2) immunohistochemistry (IHC). Two pathologists assessed the sections independently. Raw scores and clinically significant groupings were compared. RESULTS: Concordance for ER, PR, overall hormone receptor (HR), and HER-2 status was seen in 86%, 83%, 90%, and 80% of patients, respectively. The core was positive, while the surgical specimen was negative in 13%, 11%, 9%, and 1% of patients, respectively. Using a log-linear model, differences in ER, PR, and HER-2 staining were all in the direction of stronger staining in the cores, and were statistically significant. Nine percent (95% CI, 4.2% to 16.4%) of women in this group would have had endocrine therapy inappropriately withheld if management decisions were based on surgical specimen results alone. CONCLUSION:ER and PR assays on core biopsy specimens are more reliable than assays on surgical specimens. Receptor IHC should be performed on core biopsy specimens to avoid patients with HR positive cancers not receiving appropriate hormonal therapy and being overtreated with systemic chemotherapy. Biopsy should be considered in patients with "receptor negative" cancer and recurrent disease.
Authors: Gemma B Uy; Adriano V Laudico; Jose M Carnate; Frederick G Lim; Arnold M Fernandez; Rona R Rivera; Cynthia A Mapua; Richard R Love Journal: Clin Breast Cancer Date: 2010-04 Impact factor: 3.225
Authors: Zsolt Hodi; Jayeta Chakrabarti; Andrew H S Lee; John E Ronan; Christopher W Elston; Kwok Leung Cheung; John F R Robertson; Ian O Ellis Journal: J Clin Pathol Date: 2006-05-26 Impact factor: 3.411
Authors: Eitan Amir; Naomi Miller; William Geddie; Orit Freedman; Farrah Kassam; Christine Simmons; Maria Oldfield; George Dranitsaris; George Tomlinson; Andreas Laupacis; Ian F Tannock; Mark Clemons Journal: J Clin Oncol Date: 2011-11-28 Impact factor: 44.544
Authors: Julia D Wulfkuhle; Daniela Berg; Claudia Wolff; Rupert Langer; Kai Tran; Julie Illi; Virginia Espina; Mariaelena Pierobon; Jianghong Deng; Angela DeMichele; Axel Walch; Holger Bronger; Ingrid Becker; Christine Waldhör; Heinz Höfler; Laura Esserman; Lance A Liotta; Karl-Friedrich Becker; Emanuel F Petricoin Journal: Clin Cancer Res Date: 2012-10-08 Impact factor: 12.531
Authors: Christopher L Tebbit; Jun Zhai; Brian R Untch; Matthew J Ellis; Holly K Dressman; Rex C Bentley; Jay A Baker; Paul K Marcom; Joseph R Nevins; Jeffrey R Marks; John A Olson Journal: Breast Cancer Res Treat Date: 2009-02-18 Impact factor: 4.872