Is preoperative core biopsy accurate in determining the hormone receptor status in women with invasive breast cancer?

Sarakbi, W Al; Salhab, Mohamed; Thomas, Val; Mokbel, Kefah

doi:10.1186/1477-7800-2-15

Cited by 29 publications

(3 citation statements)

References 13 publications

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“…Nevertheless, a greater distribution and bigger change of proportion score from both two biopsy specimens to surgical excisions were noted for PgR than ER ( Figures 3A, B ). These findings above are consistent with previous studies which may be due to the reason that PgR is more heterogeneously distributed ( 26 , 35 , 36 ). Identifying HER2-positive breast malignant tumor patients prior to surgery is important since neoadjuvant or postoperative adjuvant HER2-targeted therapy is an effective option for these patients.…”

Section: Discussionsupporting

confidence: 93%

A retrospective comparative study on the diagnostic efficacy and the complications: between CassiII rotational core biopsy and core needle biopsy

Xie,

Ju,

Zhang

et al. 2023

Front. Oncol.

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Accurate pathologic diagnosis and molecular classification of breast mass biopsy tissue is important for determining individualized therapy for (neo)adjuvant systemic therapies for invasive breast cancer. The CassiII rotational core biopsy system is a novel biopsy technique with a guide needle and a “stick-freeze” technology. The comprehensive assessments including the concordance rates of diagnosis and biomarker status between CassiII and core needle biopsy were evaluated in this study. Estrogen receptor (ER), progesterone receptor (PgR), human epidermal growth factor receptor 2 (HER2), and Ki67 were analyzed through immunohistochemistry. In total, 655 patients with breast cancer who underwent surgery after biopsy at Sir Run Run Shaw Hospital between January 2019 to December 2021 were evaluated. The concordance rates (CRs) of malignant surgical specimens with CassiII needle biopsy was significantly high compared with core needle biopsy. Moreover, CassiII needle biopsy had about 20% improvement in sensitivity and about 5% improvement in positive predictive value compared to Core needle biopsy. The characteristics including age and tumor size were identified the risk factors for pathological inconsistencies with core needle biopsies. However, CassiII needle biopsy was associated with tumor diameter only. The CRs of ER, PgR, HER2, and Ki67 using Cassi needle were 98.08% (kappa, 0.941; p<.001), 90.77% (kappa, 0.812; p<.001), 69.62% (kappa, 0.482; p<.001), and 86.92% (kappa, 0.552; p<.001), respectively. Post-biopsy complications with CassiII needle biopsy were also collected. The complications of CassiII needle biopsy including chest stuffiness, pain and subcutaneous ecchymosis are not rare. The underlying mechanism of subcutaneous congestion or hematoma after CassiII needle biopsy might be the larger needle diameter and the effect of temperature on coagulation function. In summary, CassiII needle biopsy is age-independent and has a better accuracy than CNB for distinguishing carcinoma in situ and invasive carcinoma.

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Section: Discussionsupporting

confidence: 93%

A retrospective comparative study on the diagnostic efficacy and the complications: between CassiII rotational core biopsy and core needle biopsy

Xie,

Ju,

Zhang

et al. 2023

Front. Oncol.

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“…However, immunohistochemistry (IHC) assessment in CNB samples may be less reliable than in surgical specimens' due to the relatively smaller sample size and tumor heterogeneity [ 3 4 ]. Several studies have reported the concordance between preoperative CNB and surgical specimens for estrogen receptor (ER), and human epidermal growth factor receptor 2 (HER2) determination [ 5 6 7 ]. A recent meta-analysis has shown that the CNB tissue could replace open excision biopsy for determining ER, progesterone receptor (PR), and HER2 status [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Core Needle Biopsy and Surgical Specimens in Determining Intrinsic Biological Subtypes of Breast Cancer with Immunohistochemistry

et al. 2017

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PurposeWe evaluated the concordance between core needle biopsy (CNB) and surgical specimens on examining intrinsic biological subtypes and receptor status, and determined the accuracy of CNB as a basic diagnostic method.MethodsWe analyzed breast cancer patients with paired CNB and surgical specimen samples during 2014. We used monoclonal antibodies for nuclear staining, and estrogen receptor (ER) and progesterone receptor (PR) status evaluation. A positive test was defined as staining greater than or equal to 1% of tumor cells. Human epidermal growth factor receptor 2 (HER2) was graded by immunohistochemistry and scored as 0 to 3+ according to the recommendations of the American Society of Clinical Oncology/College of American Pathologists. Ki-67 immunostaining was performed using the monoclonal antibody Ki-67, and the results were divided at 10% intervals. The cutoff value for high Ki-67 was defined as 20%. Concordance analysis of ER, PR, HER2, Ki-67, and five intrinsic biological subtypes was performed on CNB and surgical specimens. Statistical analysis for concordance was calculated using κ-tests.ResultsWe found very good agreement for ER and PR with a concordance of 96.7% for ER (κ=0.903), and 94.3% for PR (κ=0.870). HER2 and Ki-67 showed concordance rates of 84.8% (κ=0.684) and 83.5% (κ=0.647), respectively, which were interpreted as good agreement. Five subgroups analysis showed 85.8% agreement and κ-value of 0.786, also indicating good agreement.ConclusionCNB showed high diagnostic accuracy compared with surgical specimens, and good agreement for ER, PR, HER2, and Ki-67. Our findings reaffirmed the recommendation of CNB as an initial procedure for breast cancer diagnosis, and the assessment of receptor status and intrinsic biological subtypes to determine further treatment plans.

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“…Valuable prognostic information is provided by the ER, PR, HER2 Neu and Ki-67 status of these samples and thus the response of the tumor to neoadjuvant and adjuvant chemotherapy can be predicted. [9] The CNB specimen may be the only available pretreatment tissue sample for assays of prognostic and predictive markers in some breast cancer patients, chiefly those patients who have been treated earlier with preoperative chemotherapy or neoadjuvant endocrine therapy. Cytotoxic chemotherapy may cause adequate tumor regression which can alter the histological, hormonal and proliferative markers.…”

Section: Introductionmentioning

confidence: 99%

Concordance Between Core Needle Biopsy and Surgical Specimens in Determining Molecular Biological Subtypes of Breast Cancer by Immunohistochemistry

Dutta,

Chowdhury,

Sarkar

et al. 2023

JMSH

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Background: Breast carcinoma is the most common malignancy among women around the world. Core needle biopsy provides samples that are adequate in size thus allowing a histological diagnosis of breast carcinomas. CNB specimens can also be used for the immunohistochemical (IHC) assays of hormone receptors. Aims: To evaluate the concordance of ER, PR, HER2 Neu and Ki-67 in core needle biopsy and surgical specimens obtained by Modified radical mastectomy (MRM). Methods: A cross-sectional observational study was conducted in the Department of Pathology in association with the Department of Surgery at Murshidabad Medical College and Hospital for a duration of one and a half years. Patients undergoing Core needle biopsy of the breast who have been diagnosed with breast carcinoma on the basis of histopathology report and subsequently planned for MRM who have given consent for the study were included in this study. The samples were classified according to the immunohistochemical staining into four molecular subtypes: Luminal A, Luminal B, HER 2 Neu enriched, and triple-negative subtype depending on the expression of ER, PR, HER 2 Neu, and Ki-67. Result: The most common molecular subtype of breast carcinoma in both CNB and MRM specimens was the Triple-negative subtype. Conclusion: CNB has been found to be a reliable diagnostic tool that can help in determining Histopathological biomarkers for ER, PR positive, and HER2 Neu positive or negative tumors and it has also been found that retesting these markers again on the surgical specimens may not be necessary. Keywords: Core needle biopsy, Breast carcinoma, Molecular subtyping, Immunohistochemistry

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Is preoperative core biopsy accurate in determining the hormone receptor status in women with invasive breast cancer?

Cited by 29 publications

References 13 publications

A retrospective comparative study on the diagnostic efficacy and the complications: between CassiII rotational core biopsy and core needle biopsy

A retrospective comparative study on the diagnostic efficacy and the complications: between CassiII rotational core biopsy and core needle biopsy

Comparison of Core Needle Biopsy and Surgical Specimens in Determining Intrinsic Biological Subtypes of Breast Cancer with Immunohistochemistry

Concordance Between Core Needle Biopsy and Surgical Specimens in Determining Molecular Biological Subtypes of Breast Cancer by Immunohistochemistry

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