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Is it practical to determine the therapeutic strategy for breast cancer by evaluating pathological findings in core needle biopsy specimens?

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Title: Is it practical to determine the therapeutic strategy for breast cancer by evaluating pathological findings in core needle biopsy specimens?
Authors: Yamanouchi, Kosho / Minami, Shigeki / Kuba, Sayaka / Kawakami, Fusako / Sakimura, Chika / Kinoshita, Naoe / Abe, Kuniko / Hayashi, Tomayoshi / Kuroki, Tamotsu / Eguchi, Susumu
Issue Date: Dec-2014
Publisher: Nagasaki University School of Medicine / 長崎大学医学部
Citation: Acta medica Nagasakiensia, 59(2), pp.41-45; 2014
Abstract: Background; Core needle biopsy (CNB) specimens have been widely used not only for the diagnosis of breast cancer, but also for assessing biomarkers, including lymphovascular invasion (ly and v), nuclear grading, the estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2) and Ki-67. We herein compared the pathological biomarkers of ER+/HER2- invasive breast cancers in CNB with those in the subsequent surgical specimens.  Methods; Patients with ER+/HER2- invasive breast cancer who presented to our department from August 2011 to July 2013 who had CNB and subsequent surgery were included. Lymphovascular invasion (ly, v) and nuclear grading were determined by hematoxylin and eosin staining, and the ER, PgR, HER-2, and Ki-67 status were evaluated by immunohistochemistry.  Results; The concordance rates between CNB and surgical specimens for the ly, v, nuclear grading, ER and PgR were 2.4%, 2.9%, 63.0%, 96.4% and 82.1%, respectively. Lymphovascular invasion and nuclear grading tended to be underestimated with CNB in discordant cases. The Ki-67 labeling index in CNB specimens was strongly correlated with that in surgical specimens (correlation coefficient 0.75, p<0.0001). Consequently, there was a reasonable level of agreement between CNB and surgical specimens for surrogate subtyping (82.1%).  Conclusions; CNB provided reliable information on the expression of hormone receptors, Ki-67 in ER+/HER2- invasive breast cancers. However, because of the substantial discordance between CNB and surgical specimens, the status of lymphovascular invasion and nuclear grading should not be concluded based on CNB specimens.
Keywords: breast cancer / core needle biopsy / hormone receptor / Ki-67 / lymphovascular invasion
URI: http://hdl.handle.net/10069/34977
ISSN: 00016055
Type: Departmental Bulletin Paper
Text Version: publisher
Appears in Collections:Volume 59, No. 2

Citable URI : http://hdl.handle.net/10069/34977

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