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Surgical specimen can be replaced by core samples in assessment of ER, PR and HER-2 for invasive breast cancer.

Author(s): Sutela A, Vanninen R, Sudah M, Berg M, Kiviniemi V, Rummukainen J, Kataja V, Kärjä V

Publication: Acta Oncol, 2008, Vol. 47, Page 38-46

PubMed ID: 17851859 PubMed Review Paper? No

Purpose of Paper

The purpose of this paper was to compare stereotactic core needle biopsies (SCNB) with surgical specimens for assessment of estrogen (ER), progesterone (PR) and human epidermal growth-factor (HER-2) receptors in breast carcinomas.

Conclusion of Paper

Concordance between immunohistochemical (IHC) staining of surgical specimens and SCNB was observed in 83% of cases for ER, and 88% of cases for PR and HER-2, and 93% of cases if HER-2 in situ hybridization (ISH) was also performed. The discordant specimens most often occurred due to false negative results in surgical specimens. The center and margins of the tumor were concordant 100% of the time for ER, but only 85% of the time for PR and HER-2. The use of three core specimens for IHC staining allowed for 95% sensitivity for ER, and 92% for PR and HER-2, however, the sensitivity increased to 100% if HER-2 ISH was also performed. The addition of further specimens did not increase ER sensitivity, but did increase sensitivity of PR to 100%. In conclusion, SCNB were more sensitive than surgical specimens for ER, PR, and HER-2 staining, but it was necessary to analyze multiple SCNB.

Studies

  1. Study Purpose

    The purpose of this study was to compare IHC staining of ER, PR and HER-2 in SCNB and surgical specimens from breast carcinomas. SCNB from the tumor center versus 2 mm away were also compared.

    Summary of Findings:

    Concordance between IHC staining of surgical specimens and SCNB was observed in 83% of cases for ER, and 88% of cases for PR and HER-2, and 93% of cases if HER-2 ISH was also performed. The false negative rate from surgical specimens was 14% for ER, 15% for PR and 7% for HER-2 (when ISH was included). In contrast, false negatives in SCNB did not occur for PR and HER-2 (with ISH) and occurred in only 6% of specimens for ER. The center and margins of the tumor were concordant 100% of the time for ER but only 85% of the time for PR and HER-2. The use of three core specimens for IHC staining allowed for 95% sensitivity for ER, and 92% for PR and HER-2, however, the sensitivity increased to 100% for HER-2 if ISH was also used. The addition of further specimens did not increase ER sensitivity, but did increase sensitivity of PR to 100%. In conclusion, SCNB were more sensitive than surgical specimens for ER, PR, and HER-2 staining, but it was necessary to analyze multiple SCNB.

    Biospecimens
    Preservative Types
    • Formalin
    Diagnoses:
    • Neoplastic - Carcinoma
    Platform:
    AnalyteTechnology Platform
    Protein Immunohistochemistry
    DNA In situ hybridization
    Morphology H-and-E microscopy
    Pre-analytical Factors:
    ClassificationPre-analytical FactorValue(s)
    Immunohistochemistry Specific Targeted peptide/protein Estrogen receptor
    Progesterone receptor
    Human epidermal growth-factor receptor
    In situ hybridization Specific Targeted nucleic acid Human epidermal growth-factor receptor
    Biospecimen Aliquots and Components Biospecimen heterogeneity Biospecimen core
    Biospecimen periphery
    Biospecimen Acquisition Method of tissue acquisition Core needle biopsy
    Surgical resection
    View more

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