A Prospective Study on Level of Concordance Between Core Needle Biopsy and Surgical Specimen for Assessing Oestrogen Receptor, Progesterone Receptor, and Her2/Neu Receptor Status in Carcinoma Breast and Its Implications on Treatment Decisions

Abstract

A prospective study on the level of concordance between core needle biopsy specimen (CNB) and surgical specimen (SS) assesses the oestrogen receptor (ER), progesterone receptor (PR) and Her2/Neu receptor status in Carcinoma breast and its implications on treatment decisions. Ninety consecutive treatment naive operable breast cancer patients treated between September 2015 and April 2017 were included in our prospective study. All patients underwent core needle biopsy prior to definitive surgery. Immunohistochemistry (IHC) studies for ER, PR, and Her2/Neu receptor assay were done in both the CNB specimen and SS. The concordances between CNB specimen and SS for ER, PR, and Her2/Neu receptor were 92%, 88%, and 78% respectively. In our study, overall discordance for ER, PR, and Her2/Neu status based on IHC tests on CNB specimen and its corresponding SS was 41% (37 out of total 90 patients), which was mostly for Her2/Neu (20 patients). Altogether, there was a change in treatment decision based on IHC test results of CNB specimen for 14 out of 37 discordant tests, translating to 15% of the overall study group. Four patients received adjuvant hormonal therapy, and 10 patients got adjuvant Traztuzumab added to their protocol. There is almost perfect to substantial concordance between CNB specimen and SS of IHC tests for ER and PR status. However, the concordance for Her2/Neu receptor is only moderate. Her2/Neu receptor assay by IHC is more sensitive in CNB specimen than in SS.

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References

  1. 1.

    Yildiz-Aktas IZ, Dabbs DJ, Bhargava R (2012 Aug) The effect of cold ischemic time on the immunohistochemical evaluation of estrogen receptor, progesterone receptor, and HER2 expression in invasive breast carcinoma. Mod Pathol 25(8):1098–1105

    CAS  Article  Google Scholar 

  2. 2.

    Arnedos M, Nerurkar A, Osin P, A'Hern R, Smith IE, Dowsett M (2009) Discordance between core needle biopsy (CNB) and excisional biopsy (EB) for estrogen receptor (ER), progesterone receptor (PR) and HER2 status in early breast cancer (EBC). Ann Oncol 20:1948–1952

    CAS  Article  Google Scholar 

  3. 3.

    You K, Park S, Ryu JM, Kim I, Lee SK, Yu J, Kim SW, Nam SJ, Lee JE (2017 Sep 1) Comparison of core needle biopsy and surgical specimens in determining intrinsic biological subtypes of breast cancer with immunohistochemistry. J Breast Cancer 20(3):297–303

    Article  Google Scholar 

  4. 4.

    Ricci M, Calvano Filho C, de Oliveira FH et al (2012) Analysis of the concordance rates between core needle biopsy and surgical excision in patients with breast cancer. Revista da Associação Médica Brasileira (English Edition) 58(5):532–536

    Article  Google Scholar 

  5. 5.

    Asogan AB, Hong GS, Prabhakaran SK (2017 Mar) Concordance between core needle biopsy and surgical specimen for oestrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 status in breast cancer. Singap Med J 58(3):145–149

    Article  Google Scholar 

  6. 6.

    Chen X, Sun L, Mao Y, Zhu S, Wu J, Huang O, Li Y, Chen W, Wang J, Yuan Y, Fei X, Jin X, Shen K (2013 Dec) Preoperative core needle biopsy is accurate in determining molecular subtypes in invasive breast cancer. BMC Cancer 13(1):390

    Article  Google Scholar 

  7. 7.

    Seferina SC, Nap M, van den Berkmortel F, Wals J, Voogd AC, Tjan-Heijnen VCG (2013) Reliability of receptor assessment on core needle biopsy in breast cancer patients. Tumour Biol 34:987–994

    CAS  Article  Google Scholar 

  8. 8.

    Dekker TJ, Smit VT, Hooijer GK et al (2013) Reliability of core needle biopsy for determining ER and HER2 status in breast cancer. Ann Oncol 24:931–937

    CAS  Article  Google Scholar 

  9. 9.

    Ough M, Velasco J, Hieken TJ (2011) A comparative analysis of core needle biopsy and final excision for breast cancer: histology and marker expression. Am J Surg 201:692–694

    Article  Google Scholar 

  10. 10.

    Tamaki K, Sasano H, Ishida T, Miyashita M, Takeda M, Amari M, Tamaki N, Ohuchi N (2010 Sep) Comparison of core needle biopsy (CNB) and surgical specimens for accurate preoperative evaluation of ER, PgR and HER2 status of breast cancer patients. Cancer Sci 101(9):2074–2079

    CAS  Article  Google Scholar 

  11. 11.

    Pettine S, Place R, Babu S, Williard W, Kim D, Carter P (1996) Stereotactic breast biopsy is accurate, minimally invasive, and cost effective. Am J Surg 171:474–476

    CAS  Article  Google Scholar 

  12. 12.

    Pijnappel RM, van Dalen A, Borel Rinkes IH et al (1997) The diagnostic accuracy of core biopsy in palpable and non-palpable breast lesions. Eur J Radiol 24:120–123

    CAS  Article  Google Scholar 

  13. 13.

    Chen X, Yuan Y, Gu Z, Shen K (2012) Accuracy of estrogen receptor, progesterone receptor, and HER2 status between core needle and open excision biopsy in breast cancer: a meta-analysis. Breast Cancer Res Treat 134:957–967

    CAS  Article  Google Scholar 

  14. 14.

    Hammond ME, Hayes DF, Dowsett M et al (2010) American Society of Clinical Oncology/College Of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 28:2784–2795

    Article  Google Scholar 

  15. 15.

    Uy GB, Laudico AV, Carnate JM Jr, Lim FG, Fernandez AM, Rivera RR, Mapua CA, Love RR (2010 Apr 1) Breast cancer hormone receptor assay results of core needle biopsy and modified radical mastectomy specimens from the same patients. Clinical breast cancer 10(2):154–159

    Article  Google Scholar 

  16. 16.

    Quinn E, Salter J, Hills M, et al (2008) Concordance between tissue microarray and whole tissue sections for ER expression and PR and HER-2 Status: a pilot study for the Trans-ATAC trial. Eur J Cancer Suppl 6:140 (Abstr 311)

  17. 17.

    Konecny G, Pauletti G, Pegram M, Untch M, Dandekar S, Aguilar Z, Wilson C, Rong HM, Bauerfeind I, Felber M, Wang HJ, Beryt M, Seshadri R, Hepp H, Slamon DJ (2003) Quantitative association between HER-2/neu and steroid hormone receptors in hormone receptor positive primary breast cancer. J Natl Cancer Inst 95:142–153

    CAS  Article  Google Scholar 

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Correspondence to Dileep Damodaran.

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Damodaran, D., Naidu, B.K., Varghese, J.C. et al. A Prospective Study on Level of Concordance Between Core Needle Biopsy and Surgical Specimen for Assessing Oestrogen Receptor, Progesterone Receptor, and Her2/Neu Receptor Status in Carcinoma Breast and Its Implications on Treatment Decisions. Indian J Surg Oncol (2020). https://doi.org/10.1007/s13193-020-01146-y

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Keywords

  • Concordance
  • Core needle biopsy
  • Oestrogen receptor
  • Her2
  • Progesterone receptor
  • Immunohistochemistry