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

Kombak, Faruk Erdem; Şahin, Hülya; Hande, M. Prakash; Önem, Idris; Kaya, Handan; Bugdayci, Onur; Arıbal, Erkin

doi:10.3906/sag-1702-152

Cited by 11 publications

(27 citation statements)

References 30 publications

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“…Onestep discordance was 26% (13/50), and there was no twostep discordance. To investigate the low and midrange-risk categories, we also applied low (< 11), intermediate (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) and high (≥ 26) cutoffs, and the RS concordance between paired resection specimens and CNBs as categorical variables was 72%. A total of 14 tumours showed one-step discordance; similarly, there was still no two-step discordance.…”

Section: Discussionmentioning

confidence: 99%

“…RS, ranging from 0 to 100, was derived from the reference-normalized expression measurements for the 16 cancer-related genes. Patients were then categorized into low-risk (< 18), intermediate-risk (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), and high-risk (≥ 31) groups [12]. We also investigated low-and midrange-risk groups as follows: low (< 11), intermediate (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), and high (≥ 26) [39][40][41].…”

Section: Rna Extraction Amplification and Gene Expression Analysis By Rt-pcrmentioning

confidence: 99%

“…Although several sets of guidelines recommend this assay for HR + , lymph node-negative, earlystage BC [19][20][21][22], it has not been compared head-to-head between CNBs and resection specimens, and little data are available regarding the correlation of RS in these specimen types. Previously, several studies have demonstrated concordant and discordant IHC findings regarding the ER, PR, HER-2 and Ki-67 status of breast lesions between CNBs and resection specimens [23][24][25]. Patients with false-negative test results may be undertreated, whereas patients with false-positive results may receive unnecessary treatment with expensive drugs, potentially causing serious side effects.…”

Section: Introductionmentioning

confidence: 99%

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Concordance of the 21-gene assay between core needle biopsy and resection specimens in early breast cancer patients

Pan

Bai

et al. 2021

Breast Cancer Res Treat

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Background Adjuvant therapy decisions may be partly based on the results of a multigene quantitative reverse transcription-polymerase chain reaction (RT-PCR)-based assay: the 21-gene recurrence score (RS) test of resection specimens. When necessary, core needle biopsy (CNB) may be considered as a surrogate. Here, we evaluated the concordance in gene expression according to results from RT-PCR-based RS testing between paired CNBs and resection specimens. Methods CNBs and resection specimens from 50 breast cancer (BC) patients were tested to calculate RSs. First, we examined the concordance of the ER, PR and HER-2 status of tissue samples indicated by immunohistochemical (IHC) and RT-PCR analyses. Then, we compared the IHC findings of ER, PR, HER-2 and Ki-67 staining across paired samples. Ultimately, the RS and single-gene results for ER, PR, HER-2 and Ki-67 were explored between paired samples. Results The concordance between IHC and RT-PCR was 100%, 80.0% and 100% for ER, PR and HER-2, respectively, in both resection specimens and CNBs. The concordance for IHC ER, PR, HER-2 and Ki-67 status was 100%, 94.0%, 52.0% and 82.0%, respectively, between paired samples. RS results from paired samples showed a strong correlation. The overall concordance in RS group classification between samples was 74%, 72% and 78% based on traditional cutoffs, TAILORx cutoffs and ASCO guidelines, respectively. ER, PR, HER-2 and Ki-67 were modestly- to- strongly correlated between paired samples according to the RT-PCR results. Conclusion A modest- to- strong correlation of ER, PR, HER-2 and Ki-67 gene expression and RS between CNBs and resection specimens was observed in the present study. The 21-gene RS test could be reliably performed on CNBs. ER, PR and HER-2 status showed remarkable concordance between the IHC and RT-PCR analyses. The concordance between paired samples was high for the IHC ER, PR and Ki-67 results and low for HER-2.

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Section: Discussionmentioning

confidence: 99%

Section: Rna Extraction Amplification and Gene Expression Analysis By Rt-pcrmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Concordance of the 21-gene assay between core needle biopsy and resection specimens in early breast cancer patients

Pan

Bai

et al. 2021

Breast Cancer Res Treat

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“…The use of US elastography for the diagnosis of breast lesions is promising, especially in BIRADS 4 lesions. Previous studies have reported that the addition of elastography to B‐mode US increased the sensitivity of the malignant benign distinction of BIRADS 4 lesions by 96% and increased the specificity of this distinction by up to 95% 18‐22 . Factors such as cellular activation of the tumor, apoptosis, amounts of fibroblasts and fibrosis, changes in the extracellular matrix, collagen structure, integrin, and focal adhesion kinase increase the stiffness of the tissues in malignant tumors 16,26,27 .…”

Section: Discussionmentioning

confidence: 99%

“…Despite the many advantages of core‐needle biopsy, it does not always completely and consistently reflect the biological features of the examined tumor due to intratumoral heterogeneity and methodological flaws. Previous studies have shown that consistency after resection by biopsy decreases to 77.8% for ER, 69% for PR, and 60% for HER2 18‐22 . Elastography‐based biopsy, which has been practiced for years in the diagnosis of prostate cancer, increases sensitivity as well as specificity and reduces the need for re‐biopsy 23 .…”

Section: Introductionmentioning

confidence: 99%

Shear‐Wave Elastography‐Guided Core Needle Biopsy for the Determination of Breast Cancer Molecular Subtype

Peker

Balci

Akin

et al. 2020

J of Ultrasound Medicine

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Objective To investigate whether shear‐wave elastography (SWE) guidance during core‐needle biopsy can improve diagnostic accuracy and accurate determination of the molecular subtypes of breast cancer. Methods This controlled, randomized prospective cohort study included 58 patients (mean age: 56.9 ± 16.2) who were referred for image‐guided core‐needle biopsy between May 2018 and April 2019 for lesions larger than 1 cm. In Group 1, 30 lesions were biopsied without SWE guidance and recorded as Biopsy A. In Group 2, 30 lesions were examined with SWE before biopsy, and then two different parts of the lesions were biopsied; biopsies from the relatively rigid areas of the lesions were recorded as Biopsy B, and biopsies from the less rigid areas of the lesions were recorded as Biopsy C. The histopathological and immunohistochemical results of biopsies were compared with the surgical results. Results The sensitivity of Biopsy A, B and C were 96.7%, 100% and 100%, respectively. The benign‐malignant concordance rates were 94.7%, 100%, and 90% and the diagnostic concordance rates were 89.5%, 100%, and 90% in Biopsies A, B, and C, respectively. When the 10% differences in the estrogen receptor (ER), progesterone receptor (PR), and Ki67 rates were considered significant, the concordance rate of ER was highest in Biopsy B (77.8%; p = 0.040). The concordance rate of immunohistochemical subtyping was 100% in Biopsy B and 71.4% in Biopsies A and C (p = 0.086). Conclusion SWE‐guided core‐needle biopsy of breast lesions increased the sensitivity, diagnostic accuracy, and accuracy of immunohistochemical subtyping to 100%.

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Concordance of breast cancer biomarker testing in core needle biopsy and surgical specimens: A single institution experience

et al. 2022

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Background Accurate diagnostic biomarker testing is crucial to treatment decisions in breast cancer. Biomarker testing is performed on core needle biopsies (CNB) and is often repeated in the surgical specimen (SS) after resection. As differences between CNB and SS testing may alter treatment decisions, we evaluated concordance between CNB and SS as well as associated changes in treatment and clinical outcomes. Methods We performed a retrospective analysis of breast cancer patients at our institution between January 2010 and May 2020. Concordance between CNB and SS was assessed for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). Survival in patients, including recurrence, metastatic recurrence, and death, were assessed using chi‐squared likelihood ratio. Results In total, 961 patients met eligibility criteria. Concordance, minor discordance, total concordance (concordance plus minor discordance), and major discordance between CNB and SS were reported for ER (87.7%, 9.2%, 90.8%, and 2.9%), PR (58.1%, 29.1%, 87.2%, and 12.8%), and HER2 IHC (52.5%, 20.9%, 73.4%, 26.6%), respectively. HER2 FISH concordance and major discordance were 58.5% and 1.2%, respectively. Of major discordance, ER (48.2%, p < 0.001) and HER2 FISH (50.0%) led to more management changes than HER2 IHC (2.4%, p = 0.04) and PR (1.6%, p = 0.10). Patients with ER major discordance had increased risk of death (6.7% concordance vs. 22.2% major discordance, p = 0.004). Conclusion Overall, retesting ER and HER2 was more clinically beneficial than retesting PR. To aid decision‐making and minimize healthcare costs, we propose patient‐centered guidelines on retesting biomarker profiles.

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

Cited by 11 publications

References 30 publications

Concordance of the 21-gene assay between core needle biopsy and resection specimens in early breast cancer patients

Concordance of the 21-gene assay between core needle biopsy and resection specimens in early breast cancer patients

Shear‐Wave Elastography‐Guided Core Needle Biopsy for the Determination of Breast Cancer Molecular Subtype

Concordance of breast cancer biomarker testing in core needle biopsy and surgical specimens: A single institution experience

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