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Comparative study of the immunohistochemical detection of hormone receptor status and HER2 expression in primary and paired recurrent/metastatic lesions of patients with breast cancer

Comparative study of the immunohistochemical detection of hormone receptor status and HER2 expression in primary and paired recurrent/metastatic lesio

Comparative study of the immunohistochemical detection of hormone receptor status and HER2 expression in primary and paired recurrent/metastatic lesions of patients with breast cancer   (Citations: 4)
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Recent studies have shown some degrees of discordance in ER, PR and HER-2 immunohistochemical expression between primary and recurrent/metastatic lesions (RML). Analysis was made on 78 patients with MBC whose ER, PR and/or HER-2 status were known both on the tissue samples of primary and RML. Among the RML sites, 29.5% were locoregional, 70.5% were distant metastatic sites. Among 75 patients with known ER expression on both primary and RML, 36% (n = 27) showed discordance on ER expression. Among 72 patients with known PR expression on both primary and RML, 54.2% (n = 39) showed discordance on PR expression. Among 61 patients with known HER-2 expression on both primary and RML, 14.7% (n = 9) showed discordance on HER-2 expression. No differences were observed when we compared patients who have discordant ER and HER-2 status with patients who have concordant results between the primary tumor and paired RML with respect to site of biopsy (locoregional vs distant metastasis) and prior therapies (chemotherapy and endocrine therapy). As these discordant results make changes in treatment decision, a biopsy of the metastatic lesion could be recommended in patients with MBC when feasible. Larger series are needed to identify the potential effect of prior therapies and site of metastasis on discordant results.
Journal: Medical Oncology - MED ONCOL , vol. 28, no. 1, pp. 57-63, 2011
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    • ...Studies of paired samples of the primary tumor and locally/regionally recurrent or distant metastases suggest that tumor receptor status may be discordant in a significant proportion of patients: 18% to 54% for ER, 36% to 54% for PR, and 3% to 22% for HER2 in both retrospective series [6,10-14] and small prospective series [15-17]...
    • ...In contrast to the diagnosis of primary disease, biopsy of relapsed, locoregional, or distant metastatic breast cancer is not widely established in routine clinical practice, despite evidence suggesting that such a biopsy may influence patient management [3-5,14,17]...
    • ...However, no difference in receptor switch with respect to locoregional or distant site of recurrence was found (Table 3), confirming a large retrospective review [14]...
    • ... of borderline statistical significance regardless of which scoring system was used, despite the pre-study statistical power calculations based on the primary endpoint of change in ER. The changes were in keeping with a recent 25-patient prospective study [17] and the discordance between the primary and recurrent disease in up to 36% of patients for ER and up to 54.2% for PR, and gain was less common than loss of ER or PR (reviewed in [ ...
    • ...Despite interpretational difficulties and issues of tumor heterogeneity, most, but not all [13,28], retrospective series report discordance between the primary and relapsed disease, usually gain of HER2 [14,29] rather than loss of HER2 [14,30]...
    • ...Despite interpretational difficulties and issues of tumor heterogeneity, most, but not all [13,28], retrospective series report discordance between the primary and relapsed disease, usually gain of HER2 [14,29] rather than loss of HER2 [14,30]...
    • ...Although prior therapies were not associated with a change in receptors [14] (loss of ER or PR was confirmed as the most common change in receptor status [14-17]), changes from ER-negative to ER-positive in 2.2% (by Allred score) and PR-negative to PR-positive in 12 patients (8.8%) were observed...
    • ...Although prior therapies were not associated with a change in receptors [14] (loss of ER or PR was confirmed as the most common change in receptor status [14-17]), changes from ER-negative to ER-positive in 2.2% (by Allred score) and PR-negative to PR-positive in 12 patients (8.8%) were observed...

    Alastair M Thompsonet al. Prospective comparison of switches in biomarker status between primary...

    • ...This event has been reported by other authors [4, 9, 11, 15, 17, 19, 20, 23, 27]...
    • ...Most of previous papers, investigating the difference in hormone receptor status between DM and LR, have shown a similar rate of discordance between DM and LR [17, 20, 23, 27], while Idirisinghe et al. demonstrated a higher rate of discordance for both ER and PR in DM [4]...

    Giuseppe Boginaet al. Comparison of hormonal receptor and HER2 status between breast primary...

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