Prognostic impact of discordance in hormone receptor status between primary and recurrent sites in the patients with recurrent breast cancer
Abstract Introduction Recent retrospective studies have reported discordance rate of HR and HER2 statuses between primary and recurrent tumors and prognostic values of discordance. However, the results of these reports may possibly include analytical error. Patients and Methods We analyzed 153 patie...
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Veröffentlicht in: | Clinical breast cancer 2016-08, Vol.16 (4), p.e133-e140 |
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Zusammenfassung: | Abstract Introduction Recent retrospective studies have reported discordance rate of HR and HER2 statuses between primary and recurrent tumors and prognostic values of discordance. However, the results of these reports may possibly include analytical error. Patients and Methods We analyzed 153 patients from whom pathological specimens of tumor tissues were available from both primary and recurrent sites. For all specimens, immunohistochemistry was performed for these statuses with a standardized method. Two experienced pathologists evaluated these specimens in a blinded fashion. Results The discordance rates for ER (estrogen receptor), PR (progesterone receptor), and HER2 (human epidermal growth factor receptor 2) were 18%, 26%, and 7%, respectively. Subtype changes based on HR (hormone receptor) and HER2 status occurred in 21% of patients. Clinical outcome was significantly worse in the patients with the tumors that were primarily HR-positive converted to HR-negative at recurrent sites than in the patients with the tumors in which HR status did not change or converted from HR-negative to HR-positive ( P = 0.001). Clinical outcome was also significantly worse in the patients with the primarily HR-positive tumor that converted to triple negative (TN) in the recurrence sites than in the patients with a constantly HR-positive tumor ( P < 0.001). By Cox’s multivariate analyses, loss of HR expression and conversion to TN at the recurrence sites were independently indicators of worse clinical outcome. Conclusion Discordance in HR and HER2 status often occurred between primary and recurrent breast cancer and had independent prognostic impact in the patients with recurrent breast cancer. |
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ISSN: | 1526-8209 1938-0666 |
DOI: | 10.1016/j.clbc.2016.05.014 |