Singh Kamaljeet, Wang Yihong, Marketkar Shivali, Kalife Elizabeth T, Steinhoff Margaret M
Women and Infants Hospital of Rhode Island, Department of Pathology, Providence, RI 02905, USA.
Rhode Island Hospital and Miriam Hospital, Department of Pathology, Providence, RI 02905, USA.
Hum Pathol. 2017 Jul;65:123-132. doi: 10.1016/j.humpath.2017.04.016. Epub 2017 Apr 27.
There is no consensus regarding biomarker testing on the ipsilateral breast carcinomas present in separate biopsies, irrespective of whether the biopsies are performed concurrently or consecutively. We aimed to investigate estrogen receptor (ER), progesterone receptor (PR) and HER2 concordance in ipsilateral concurrent biopsies with invasive breast tumors. Consecutive ipsilateral concurrent biopsies with invasive breast tumors were identified retrospectively. Biomarker results, histologic grade and histologic subtype among the tumors in concurrent samples were compared. ER, PR, and HER2 expression was different in 3 (2.5%), 11 (9.2%) and 7 (5.9%) cases, respectively. All ER-discordant cases were sets of ER-negative (ER-) and weak-low ER-positive (ER+), ductal subtype and histologic grade 2 or 3 tumors. All PR-discordant cases were ER+, and comprised of histologic grades 1 to 3 ductal as well as lobular tumors. All HER2 discordant cases were histologic grade 2 to 3 ductal tumors. Biomarker discordance was independent of grade and subtype discordance. We found very low biomarker discordance among tumors in concurrent samples from ipsilateral breast. Our results suggest that ER and HER2 discordance in concurrent samples is predictable. ER discordance is present only in a setting of low ER+ tumors. Low-grade ductal and/or lobular tumors are ER and HER2 concordant. HER2 discordance is noted in grade 2 to 3 ductal tumors only. Histologic subtype and grade may guide extent of biomarker testing in concurrent ipsilateral breast biopsies.
对于在单独活检中出现的同侧乳腺癌进行生物标志物检测，目前尚无共识，无论活检是同时进行还是相继进行。我们旨在研究侵袭性乳腺肿瘤同侧同时活检中雌激素受体（ER）、孕激素受体（PR）和HER2的一致性。回顾性确定侵袭性乳腺肿瘤的连续同侧同时活检。比较同时样本中肿瘤之间的生物标志物结果、组织学分级和组织学亚型。ER、PR和HER2表达分别在3例（2.5%）、11例（9.2%）和7例（5.9%）中存在差异。所有ER不一致的病例均为ER阴性（ER-）和弱低ER阳性（ER+）、导管亚型以及组织学2级或3级肿瘤。所有PR不一致的病例均为ER阳性，包括组织学1至3级的导管以及小叶肿瘤。所有HER2不一致的病例均为组织学2至3级的导管肿瘤。生物标志物不一致与分级和亚型不一致无关。我们发现同侧乳腺同时样本中的肿瘤之间生物标志物不一致的情况非常少。我们的结果表明，同时样本中ER和HER2的不一致是可预测的。ER不一致仅出现在低ER+肿瘤的情况下。低级别导管和/或小叶肿瘤的ER和HER2是一致的。HER2不一致仅在组织学2至3级的导管肿瘤中出现。组织学亚型和分级可能指导同侧同时乳腺活检中生物标志物检测的范围。
