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Concordance of Immunohistochemistry Reactivity Between Core Needle and Corresponding Mastectomy Specimens in Breast Cancer Patients.

Author

Melody S. Rosales

Related Institution

Department of Pathology - Baguio General Hospital & Medical Center

Publication Information

Publication Type
Research Report
Date
September 1, 2019-August 31, 2020

Abstract

Introduction: Core needle biopsy (CNB) had an important role in breast cancer detection and provision of information to determine therapeutic approach through immunohistochemistry (IHC) evaluation. However, many questioned the reliability of core needle biopsy due to tumor heterogeneity and small biopsy size. Variability in the concordance of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor - 2 (Her2) determination were seen worldwide and possibly inaccurate up to 20%. Thus, the aim of the study was to determine the concordance rates of breast immunohistochemistry reactivity (ER, PR, Her2) between core needle biopsy and corresponding mastectomy specimens in patients with breast cancer.


Methods: A one-year cross-sectional study was conducted on 31 breast cancer patients in Baguio General Hospital and Medical Center from September 1, 2019 to August 31, 2020. Patients underwent CNB and definitive surgery. To evaluate the concordance of ER, PR and Her-2 status, CNB and corresponding mastectomy specimens were immunohistochemically tested, assessed and compared. A detailed explanation was made and consent from each patient was obtained before testing for immunohistochemistry.


Results: In total, 31 patients were eligible for the study. Of which, majority, represented by 8 (25.81%) participants belonged to age bracket 39-45 years old, 20 (64.52%) specimens involved the left breast, 16 (51.61%) were diagnosed with Stage IIA breast cancer. The concordance rates of CNB and corresponding mastectomy specimens were 87.88% for ER and PR and 77.14% for Her-2.


Conclusion: This study showed that CNB had an excellent concordance with mastectomy specimens for ER and PR immunohistochemistry status, however, it should be cautiously used for Her-2 status especially if it had 1+ or 2+ Her-2 grade.

References

1. Tamaki, Kentaro . "Comparison of core needle biopsy (CNB) and surgical specimens for accurate preoperative evaluation of ER, PgR and HER2 status of breast cancer patients" Cancer Science, Journal of the Japanese Cancer Association 101(9): 2074-2079, January 2002-June 2009. Retrieved from: http://DOI: 10.1111/j.1349-7006.2010.01630.x
2. You, Kiho . "Comparison of Core Needle Biopsy and Surgical Specimens in Determining Intrinsic Biological Subtypes of Breast Cancer with Immunohistochemistry" Journal of Breast Cancer 20(3): 297-303, 2014. Retrieved from: http://ncbi.nlm.nih.gov/pmc/articles/PMC5620445/
3. Ricci, Marcos . "Analysis of the concordance rates between core needle biopsy and surgical excision in patients with breast cancer" Revista da Associação Médica Brasileira 58(5): 532-536, May 2011-October 2011. Retrieved from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302012000500008&lng=en&nrm=iso&tlng=en
4. Kombak, Faruk Erdem . "Concordance of immunohistochemistry between core needle biopsy and surgical resection of breast cancer" Turkish Journal of Medical Sciences 47, 1791-1796, December 2011-December 2015. Retrieved from: http://DOI: 10.3906/sag-1702-152
5. Garza-Gangemi, Adrian . "Concordance of pathologic and immunohistochemical markers between core needle biopsy and surgical specimens in invasive breast cancer" ResearchGate 1(1): 23-28, 2014. Retrieved from: https://www.researchgate.net/profile/David_Velazquez5/publication/277010555_Concordance_of_pathologic_and_immunohistochemical_markers_between_core_needle_biopsy_and_surgical_specimens_in_invasive_breast_cancer/links/555e037b08ae86c06b5f31e8/Concordance-of

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