Hormone Receptor and c-ERBB2 Status in Distant Metastatic and Locally Recurrent Breast Cancer: Pathologic Correlations and Clinical Significance

Estrogen receptor (ER), progesterone receptor (PR), and c-ERBB2 (HER2/neu) are therapeutically and prognostically important markers in the management of breast carcinoma. They are not always analyzed in distant metastatic and locally recurrent breast cancers. We compared immunohistochemical expressi...

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Bibliographic Details
Published in:American journal of clinical pathology 2010-03, Vol.133 (3), p.416-429
Main Authors: IDIRISINGHE, Pushpalatha K. A, AYE AYE THIKE, POH YIAN CHEOK, TSE, Gary Man-Kit, LUI, Philip Chi-Wai, FOOK-CHONG, Stephanie, NAN SOON WONG, PUAY HOON TAN
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Breast Neoplasms - metabolism
Breast Neoplasms - pathology
Carcinoma - metabolism
Carcinoma - secondary
Chi-Square Distribution
Female
Gynecology. Andrology. Obstetrics
Humans
Immunochemistry
Investigative techniques, diagnostic techniques (general aspects)
Kaplan-Meier Estimate
Mammary gland diseases
Medical sciences
Middle Aged
Neoplasm Recurrence, Local - metabolism
Neoplasm Recurrence, Local - pathology
Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques
Receptor, ErbB-2 - metabolism
Receptors, Estrogen - metabolism
Receptors, Progesterone - metabolism
Tumors
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Summary:Estrogen receptor (ER), progesterone receptor (PR), and c-ERBB2 (HER2/neu) are therapeutically and prognostically important markers in the management of breast carcinoma. They are not always analyzed in distant metastatic and locally recurrent breast cancers. We compared immunohistochemical expression in a series of primary breast carcinomas with their distant metastases (n = 72) and local recurrences (n = 45) and analyzed the impact of any changes on survival. Discordance rates between primary and metastatic and between primary and locally recurrent lesions, respectively, were 18% (13/72) and 13% (6/45) for ER, 42% (30/72) and 33% (15/45) for PR, and 7% (5/72) and 2% (1/45) for c-ERBB2. There was statistically significant discordance between primary and metastatic PR status (P = .017; kappa = 0.201). Among locally recurrent tumors, 15 (33%) of 45 revealed discordance for PR (P = .006; kappa = 0.366). We observed a trend for shorter survival among women with ER- metastatic and locally recurrent tumors regardless of the primary tumor ER status. Our findings suggest a benefit for routine evaluation of ER, PR, and c-ERBB2 status in distant metastatic and locally recurrent breast cancer for therapeutic and prognostic purposes.
ISSN:0002-9173
1943-7722
DOI:10.1309/AJCPJ57FLLJRXKPV