Research Article
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Comparing Between Preoperative Core Needle Biopsy and Postoperative Surgery Specimens in ER, PR, HER2 and Ki67 in Invasive Breast Cancer

Year 2022, Volume: 8 Issue: 2, 179 - 185, 01.05.2022
https://doi.org/10.53394/akd.1057735

Abstract

ABSTRACT
Objective: To compare the diagnostic and prognostic value of Estrogen receptor (ER), Progesterone receptor (PR), human epidermal growth receptor factor 2 (HER2) and Ki-67 in surgical specimen with core needle biopsies performed in invasive breast cancer.
Material and Methods: 213 breast specimens diagnosed with core needle biopsy and surgically excised were analyzed retrospectively.
Results: ER staining level in surgical specimens was correlated with core needle biopsies at a rate of 94.8% (kappa: 0.81, p <0.001) and PR staining level of 91.5% (kappa: 0.80, <0.001). When the cut-off value of 20% was used for the Ki-67 expression, the correlation rate with 90.1% was found to be high (kappa: 0.79). HER2 correlation was correlated with 98.6% (kappa: 0.93, p <0.001) when evaluated according to the results of IHC and FISH. In terms of molecular subtyping, it is statistically significant with 86.8% (Kappa: 0.79, p <0.001).
Conclusion: It was observed that core needle biopsy was reliable in terms of reflecting the biological profile of the specimen of hormone receptors such as ER, PR, and HER2.
It was thought that the inconsistency in the Ki-67 index might be due to the time between biopsy and surgery and the tissue follow-up process.
Key Words: Breast cancer, Core Needle Biopsy, ER, PR, HER2

References

  • 1. Parsa Y, Mirmalek SA, Kani FE, Aidun A, Salimi-Tabatabaee SA, Yadollah-Damavandi S, Jangholi E, Parsa T, Shahverdi E. A Review of the Clinical Implications of Breast Cancer Biology. Electronic Physician. 2016; 8(5): 2416.
  • 2. Mehrabi E, Hajian S, Simbar M, Hoshyari M, Zayeri F. Coping response following a diagnosis of breast cancer: A systematic review. Electronic physician. 2015; 7(8): 1575.
  • 3. Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thurlimann B, Senn HJ. Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol 2011; 22: 1736-47.
  • 4. Goldhirsch A, Winer EP, Coates AS, Gelber RD, Piccart-Gebhart M, Thürlimann B, Senn HJ, Panel members. Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol 2013; 24: 2206-23.
  • 5. Untch M, Konecny GE, Paepke S, von Minckwitz G. Current and future role of neoadjuvant therapy for breast cancer. Breast 2014; 23: 526-37.
  • 6. Teshome M, Hunt KK. Neoadjuvant therapy in the treatment of breast cancer. Surg Oncol Clin N Am 2014; 23: 505-23.
  • 7. Loibl S, Denkert C, von Minckwitz G. Neoadjuvant treatment of breast cancer--Clinical and research perspective. Breast 2015; 24 Suppl 2: S73-7.
  • 8. Allred DC, Harvey JM, Berardo M, Clark GM. Prognostic and predictive factors in breast cancer by immunohistochemical analysis. Mod Pathol 1998; 11: 155-68.
  • 9. Wolff AC, Hammond MEH, Allison KH, Harvey BE, Mangu PB, Bartlett JMS, Bilous M, Ellis IO, Fitzgibbons P, Hanna W, Jenkins RB, Press MF, Spears PA, Vance GH, Viale G, McShane LM, Dowsett M. Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update. J Clin Oncol 2018; 36: 2105-22.
  • 10. Cho U, Kim HE, Oh WJ, Yeo MK, Song BJ, Lee A. The Long-term Prognostic Performance of Ki-67 in Primary Operable Breast Cancer and Evaluation of Its Optimal Cutoff Value. Appl Immunohistochem Mol Morphol 2016; 24: 159-66.
  • 11. Vaidya JS, Massarut S, Vaidya HJ, Alexander EC, Richards T, Caris JA, Sirohi B, Tobias JS Rethinking neoadjuvant chemotherapy for breast cancer. BMJ. 2018; 360: j5913.
  • 12. Reyal F, Hamy AS, Piccart MJ. Neoadjuvant treatment:the future of patients with breast cancer. ESMO Open 2018; 3(4): e000371.
  • 13. Davidson TM, Rendi MH, Frederick PD, Onega T, Allison KH, Mercan E, Brunyé TT, Shapiro LG, Weaver DL, Elmore JG. Breast cancer prognostic factors in the digital era: comparison of nottingham grade using whole slide ımages and glass slides. J Pathol Inform. 2019,3;10:11
  • 14. Wolff AC, Hammond ME, Schwartz JN, Hagerty KL, Allred DC, Cote RJ, Dowsett M, Fitzgibbons PL, Hanna WM, Langer A, McShane LM, Paik S, Pegram MD, Perez EA, Press MF, Rhodes A, Sturgeon C, Taube SE, Tubbs R, Vance GH, Van de Vijver M, Wheeler TM, Hayes DF, American Society of Clinical Oncology/College of American Pathologists. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. Arch Pathol Lab Med. 2007;131(1):18-43.
  • 15. Senkus E, Kyriakides S, Penault-Llorca F, Poortmans P, Thompson A, Zackrisson S, et al. Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013; 24(Suppl 6): vi7–23.
  • 16. Greer LT, Rosman M, Mylander WC, Hooke J, Kovatich A, Sawyer K, Buras RR, Shriver CD, Tafra L. Does breast tumor heterogeneity necessitate further immunohistochemical staining on surgical specimens? J Am Coll Surg 2013; 216: 239-51.
  • 17. Chen X, Yuan Y, Gu Z, Shen K. Accuracy of estrogen receptor, progesterone receptor, and HER2 status between core needle and open excision biopsy in breast cancer: a meta-analysis. Breast Cancer Res Treat. 2012; 134(3): 957–67.
  • 18. Chen X, Sun L, Mao Y, Zhu S, Wu J, Huang O, Li Y, Chen W, Wang J, Yuan Y, Fei X, Jin X, Shen K. Preoperative core needle biopsy is accurate in determining molecular subtypes in invasive breast cancer. BMC Cancer. 2013; 13: 390.
  • 19. Ye Sul Jeong, Jun Kang, Jieun Lee, Tae-Kyung Yoo, Sung Hun Kim, Ahwon Lee. Analysis of the Molecular Subtypes of Preoperative Core Needle Biopsy and Surgical Specimens in Invasive Breast Cancer. J Pathol Transl Med. 2020; 54 (1): 87–94.
  • 20. Chen X, Zhu S, Fei X, Garfield DH, Wu J, Huang O, Li Y, Zhu L, He J, Chen W, Jin X, Shen K. Surgery time interval and molecular subtype may influence Ki67 change after core needle biopsy in breast cancer patients. BMC Cancer. 2015; 15: 822.
  • 21. Rakha EA, Ellis IO. An overview of assessment of prognostic and predictive factors in breast cancer needle core biopsy specimens. J Clin Pathol 2007; 60: 1300-6.
  • 22. Robertson S, Ronnlund C, de Boniface J, Hartman J. Re-testing of predictive biomarkers on surgical breast cancer specimens is clinically relevant. Breast Cancer Res Treat 2019; 174: 795-805.
  • 23. Chen X, Zhu S, Fei X, Garfield DH, Wu J, Huang O, et al. Surgery time interval and molecular subtype may influence Ki67 change after core needle biopsy in breast cancer patients. BMC Cancer. 2015;15:822.
  • 24. Tendl-Schulz KA, Rössler F, Wimmer P, Heber UM, Mittlböck M, Kozakowski N et al. Factors influencing agreement of breast cancer luminal molecular subtype by Ki67 labeling index between core needle biopsy and surgical resection specimens. Virchows Arch. 2020; 477(4): 545–555. Published online 2020 May 7.
  • 25. Ahn S, Lee J, Cho MS, Park S, Sung SH. Evaluation of Ki-67 Index in Core Needle Biopsies and Matched Breast Cancer Surgical Specimens. Arch Pathol Lab Med. 2018;142(3):364-368.
  • 26. Romero Q. Bendahl PO.Klintman et al. Ki67 proliferation in core biopsies versus surgical samples—a model for neo-adjuvant breast cancer studies. BMC Cancer. 2011;11:341.

İnvaziv Meme Kanserinde Preoperatif Kor İğne Biyopsi ile Postoperatif Cerrahi Spesmenler Arasında ER, PR, HER2 ve Ki67 Açısından Karşılaştırma

Year 2022, Volume: 8 Issue: 2, 179 - 185, 01.05.2022
https://doi.org/10.53394/akd.1057735

Abstract

ÖZ
Amaç: İnvaziv meme kanserinde yapılan kor iğne biyopsileri ile cerrahi spesmende Östrojen reseptörü (ER), Progesteron reseptörü (PR), insan epidermal büyüme reseptörü faktörü 2 (HER2) ve Ki-67’nin tanısal ve prognostik değerini karşılaştırmak.
Gereç ve Yöntemler: Kor iğne biyopsi ile tanı almış ve cerrahi olarak çıkarılmış 213 meme spesmeni retrospektif olarak incelendi.
Bulgular: Kor iğne biyopsiler ile cerrahi spesmenlerdeki ER boyanma düzeyi %94,8 (kappa:0,81, p < 0,001) ve PR boyanma düzeyi %91,5 (kappa:0,80, < 0.001) oranında korele olduğu görüldü. Ki-67 ifadesi için %20 cut-of değeri kullanıldığında, %90,1 ile korelasyon oranı yüksek bulundu (kappa: 0,79). HER2 korelasyonu, İHK ve FİSH sonucuna göre değerlendirildiğinde %98,6 (kappa: 0,93, p< 0,001) ile korelasyon sergiledi. Moleküler alt tiplendirme açısından %86,8 ile istatistiksel olarak anlamlıdır (Kappa:0,79, p< 0,001).
Sonuçlar: Kor iğne biyopsinin ER, PR ve HER2 gibi hormon reseptörlerinin spesmenin biyolojik profilini yansıtması açısından güvenilir olduğu gözlendi.
Ki-67 indeksindeki uyumsuzluğun biyopsi ile cerrahi arasındaki süre ve doku takip prosesinden kaynaklanabileceği düşünüldü.
Anahtar Sözcükler: Meme kanseri, Kor iğne biyopsi, ER, PR, HER2

References

  • 1. Parsa Y, Mirmalek SA, Kani FE, Aidun A, Salimi-Tabatabaee SA, Yadollah-Damavandi S, Jangholi E, Parsa T, Shahverdi E. A Review of the Clinical Implications of Breast Cancer Biology. Electronic Physician. 2016; 8(5): 2416.
  • 2. Mehrabi E, Hajian S, Simbar M, Hoshyari M, Zayeri F. Coping response following a diagnosis of breast cancer: A systematic review. Electronic physician. 2015; 7(8): 1575.
  • 3. Goldhirsch A, Wood WC, Coates AS, Gelber RD, Thurlimann B, Senn HJ. Strategies for subtypes--dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol 2011; 22: 1736-47.
  • 4. Goldhirsch A, Winer EP, Coates AS, Gelber RD, Piccart-Gebhart M, Thürlimann B, Senn HJ, Panel members. Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol 2013; 24: 2206-23.
  • 5. Untch M, Konecny GE, Paepke S, von Minckwitz G. Current and future role of neoadjuvant therapy for breast cancer. Breast 2014; 23: 526-37.
  • 6. Teshome M, Hunt KK. Neoadjuvant therapy in the treatment of breast cancer. Surg Oncol Clin N Am 2014; 23: 505-23.
  • 7. Loibl S, Denkert C, von Minckwitz G. Neoadjuvant treatment of breast cancer--Clinical and research perspective. Breast 2015; 24 Suppl 2: S73-7.
  • 8. Allred DC, Harvey JM, Berardo M, Clark GM. Prognostic and predictive factors in breast cancer by immunohistochemical analysis. Mod Pathol 1998; 11: 155-68.
  • 9. Wolff AC, Hammond MEH, Allison KH, Harvey BE, Mangu PB, Bartlett JMS, Bilous M, Ellis IO, Fitzgibbons P, Hanna W, Jenkins RB, Press MF, Spears PA, Vance GH, Viale G, McShane LM, Dowsett M. Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update. J Clin Oncol 2018; 36: 2105-22.
  • 10. Cho U, Kim HE, Oh WJ, Yeo MK, Song BJ, Lee A. The Long-term Prognostic Performance of Ki-67 in Primary Operable Breast Cancer and Evaluation of Its Optimal Cutoff Value. Appl Immunohistochem Mol Morphol 2016; 24: 159-66.
  • 11. Vaidya JS, Massarut S, Vaidya HJ, Alexander EC, Richards T, Caris JA, Sirohi B, Tobias JS Rethinking neoadjuvant chemotherapy for breast cancer. BMJ. 2018; 360: j5913.
  • 12. Reyal F, Hamy AS, Piccart MJ. Neoadjuvant treatment:the future of patients with breast cancer. ESMO Open 2018; 3(4): e000371.
  • 13. Davidson TM, Rendi MH, Frederick PD, Onega T, Allison KH, Mercan E, Brunyé TT, Shapiro LG, Weaver DL, Elmore JG. Breast cancer prognostic factors in the digital era: comparison of nottingham grade using whole slide ımages and glass slides. J Pathol Inform. 2019,3;10:11
  • 14. Wolff AC, Hammond ME, Schwartz JN, Hagerty KL, Allred DC, Cote RJ, Dowsett M, Fitzgibbons PL, Hanna WM, Langer A, McShane LM, Paik S, Pegram MD, Perez EA, Press MF, Rhodes A, Sturgeon C, Taube SE, Tubbs R, Vance GH, Van de Vijver M, Wheeler TM, Hayes DF, American Society of Clinical Oncology/College of American Pathologists. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for human epidermal growth factor receptor 2 testing in breast cancer. Arch Pathol Lab Med. 2007;131(1):18-43.
  • 15. Senkus E, Kyriakides S, Penault-Llorca F, Poortmans P, Thompson A, Zackrisson S, et al. Primary breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2013; 24(Suppl 6): vi7–23.
  • 16. Greer LT, Rosman M, Mylander WC, Hooke J, Kovatich A, Sawyer K, Buras RR, Shriver CD, Tafra L. Does breast tumor heterogeneity necessitate further immunohistochemical staining on surgical specimens? J Am Coll Surg 2013; 216: 239-51.
  • 17. Chen X, Yuan Y, Gu Z, Shen K. Accuracy of estrogen receptor, progesterone receptor, and HER2 status between core needle and open excision biopsy in breast cancer: a meta-analysis. Breast Cancer Res Treat. 2012; 134(3): 957–67.
  • 18. Chen X, Sun L, Mao Y, Zhu S, Wu J, Huang O, Li Y, Chen W, Wang J, Yuan Y, Fei X, Jin X, Shen K. Preoperative core needle biopsy is accurate in determining molecular subtypes in invasive breast cancer. BMC Cancer. 2013; 13: 390.
  • 19. Ye Sul Jeong, Jun Kang, Jieun Lee, Tae-Kyung Yoo, Sung Hun Kim, Ahwon Lee. Analysis of the Molecular Subtypes of Preoperative Core Needle Biopsy and Surgical Specimens in Invasive Breast Cancer. J Pathol Transl Med. 2020; 54 (1): 87–94.
  • 20. Chen X, Zhu S, Fei X, Garfield DH, Wu J, Huang O, Li Y, Zhu L, He J, Chen W, Jin X, Shen K. Surgery time interval and molecular subtype may influence Ki67 change after core needle biopsy in breast cancer patients. BMC Cancer. 2015; 15: 822.
  • 21. Rakha EA, Ellis IO. An overview of assessment of prognostic and predictive factors in breast cancer needle core biopsy specimens. J Clin Pathol 2007; 60: 1300-6.
  • 22. Robertson S, Ronnlund C, de Boniface J, Hartman J. Re-testing of predictive biomarkers on surgical breast cancer specimens is clinically relevant. Breast Cancer Res Treat 2019; 174: 795-805.
  • 23. Chen X, Zhu S, Fei X, Garfield DH, Wu J, Huang O, et al. Surgery time interval and molecular subtype may influence Ki67 change after core needle biopsy in breast cancer patients. BMC Cancer. 2015;15:822.
  • 24. Tendl-Schulz KA, Rössler F, Wimmer P, Heber UM, Mittlböck M, Kozakowski N et al. Factors influencing agreement of breast cancer luminal molecular subtype by Ki67 labeling index between core needle biopsy and surgical resection specimens. Virchows Arch. 2020; 477(4): 545–555. Published online 2020 May 7.
  • 25. Ahn S, Lee J, Cho MS, Park S, Sung SH. Evaluation of Ki-67 Index in Core Needle Biopsies and Matched Breast Cancer Surgical Specimens. Arch Pathol Lab Med. 2018;142(3):364-368.
  • 26. Romero Q. Bendahl PO.Klintman et al. Ki67 proliferation in core biopsies versus surgical samples—a model for neo-adjuvant breast cancer studies. BMC Cancer. 2011;11:341.
There are 26 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Pınar Celepli This is me 0000-0001-7643-6263

Pelin Seher Öztekin This is me 0000-0002-9519-6266

Salih Celepli This is me 0000-0002-3596-7938

İrem Bigat This is me 0000-0003-0067-1675

Sema Hücümenoğlu This is me 0000-0002-6898-4101

Early Pub Date April 24, 2022
Publication Date May 1, 2022
Submission Date December 21, 2020
Published in Issue Year 2022 Volume: 8 Issue: 2

Cite

Vancouver Celepli P, Öztekin PS, Celepli S, Bigat İ, Hücümenoğlu S. İnvaziv Meme Kanserinde Preoperatif Kor İğne Biyopsi ile Postoperatif Cerrahi Spesmenler Arasında ER, PR, HER2 ve Ki67 Açısından Karşılaştırma. Akd Med J. 2022;8(2):179-85.