Breast cancer hormone receptor assay results of core needle biopsy and modified radical mastectomy specimens from the same patients.

Author(s): Uy GB, Laudico AV, Carnate JM Jr, Lim FG, Fernandez AM, Rivera RR, Mapua CA, Love RR

Publication: Clin Breast Cancer, 2010, Vol. 10, Page 154-9

PubMed ID: 20299318 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   ER and PR status and Allred scores were investigated for concordance in 160 case-matched breast tissue specimens that were first obtained by core needle biopsy for initial diagnosis and later as part of a modified radical mastectomy. Masectomy specimens were sectioned to a thickness of 0.5-1 cm using the breadloaf technique prior to fixation. Specimens were collected over a period of 5 years, and fixed for 6-30 h for biopsy specimens and 24-54 h for surgically resected specimens in a formalin to tissue ratio of 1:2 to 1:3. Paraffin blocks were stored for a period of 3 months to 5 years before sectioning and analysis.

   Summary of Findings:

   All specimens included in the analysis were positive for ER or PR , and 146 of the 160 specimens were positive for both receptors (91.2%). Positivity rates for ER were 95% and 81.9% in case-matched biopsy and surgically resected specimens, respectively(p<0.001). Similarly, for PR the positivity rate was also significantly higher for biopsy compared to resected specimens (93.8% versus 86.9%, respectively; p=0.035). Overall agreement between case-matched biopsy and surgically resected specimens was 81.9% for ER (Kappa test, p=0.016) and 85.6% for PR (Kappa test, p=0.009). Of the 29 cases of discordance for ER, 21 were positive in the biopsy but negative in the resection, while 4 cases were negative in the biopsy but positive in the resection. For the 23 cases of PR discordance, 17 were positive in the biopsy but negative in the resection, while 6 cases were negative in the biopsy but positive in the resection. Mean Allred scores were higher in biopsy compared to surgically resected breast specimens, 6.6 versus 4.7 for ER (p<0.001), respectively, and 6.7 versus 6.0 for PR (p=0.001), respectively. Although data was not shown, the authors state that there were no associations between ER and PR positivity rates and year of surgery, paraffin block storage duration, or tumor size. The authors also note, but did not investigate, the potential influence of confounding variables on hormone receptor status that included differences in fixation delay and time in fixative between case-matched biospy and resected specimens.

   Biospecimens

   • Tissue - Breast

   Preservative Types

   • Formalin

   Diagnoses:

   • Neoplastic - Carcinoma

   Platform:

   Analyte	Technology Platform
   Protein	Immunohistochemistry

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Biospecimen Preservation	Time in fixative	6-30 h 24-54 h
   Storage	Storage duration	3 months- 5 years
   Biospecimen Acquisition	Method of tissue acquisition	Biopsy Surgical resection

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