Affiliation:
1. a Department of Oncology and Hematology, Modena University Hospital, Modena, Italy
2. b Department of Pathology, Modena University Hospital, Modena, Italy
Abstract
Abstract
Introduction.
The assessment of hormone receptors (HRs) and human epidermal growth factor receptor (HER)-2 is necessary to select patients who are candidates for hormonal and anti–HER-2 therapy. The evaluation of these parameters is generally carried out in primary tumors and it is not clear if reassessment in metastatic lesions might have an impact on patient management. The primary aim of this analysis was to compare HER-2 and HR status in primary tumors versus metastatic sites in breast cancer patients.
Patients and Methods.
Seventy-five patients with available samples from primary tumors and paired metastases were included. HER-2 status was evaluated by immunohistochemistry (IHC) and/or fluorescence in situ hybridization (FISH); HR status was assessed by IHC.
Results.
Nineteen percent of primary tumors were HER-2 positive; 77% were HR positive. Sites of biopsied or resected metastases were: locoregional soft tissues (n = 30), liver (n = 20), central nervous system (n = 5), bone (n = 5), pleura (n = 4), distant soft tissues (n = 3), abdomen (stomach, colon, peritoneum) (n = 3), bronchus (n = 3), and bone marrow (n = 2). For paired metastases, the HER-2 status was unchanged in 84% of cases; two patients changed from positive to negative, while 10 patients converted from negative to positive (agreement, 84%; κ = 0.5681). A change in HR status was observed in 16 cases (21%): nine cases from positive to negative and seven cases from negative to positive (agreement, 78.7%; κ = 0.4158).
Conclusions.
Further studies are necessary to better define the level of discordance in HER-2 or HR status between primary tumors and paired metastases. However, a biopsy of metastatic disease can be recommended, if feasible with minimal invasiveness, because treatment options might change for a significant proportion of patients.
Publisher
Oxford University Press (OUP)
Reference25 articles.
1. Effects of chemotherapy and hormonal therapy for early breast cancer on recurrence and 15-year survival: An overview of the randomised trials;Early Breast Cancer Trialists' Collaborative Group (EBCTCG);Lancet,2005
2. Efficacy and safety of trastuzumab as a single agent in first-line treatment of HER2-overexpressing metastatic breast cancer;Vogel;J Clin Oncol,2002
3. Assessment of Her-2/neu overexpression in primary breast cancers and their metastatic lesions: An immunohistochemical study;Masood;Ann Clin Lab Sci,2000
4. c-erbB-2 protein overexpression and p53 immunoreaction in primary and recurrent breast cancer tissues;Shimizu;J Surg Oncol,2000
5. Amplification of HER-2/neu and topoisomerase IIα in primary and metastatic breast cancer;Tanner;Cancer Res,2001
Cited by
127 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献