Multifocal/Multicentric Ipsilateral Invasive Breast Carcinomas with Similar Histology: Is Multigene Testing of All Individual Foci Necessary?
Adult
Aged
Biomarkers, Tumor
/ genetics
Breast Neoplasms
/ genetics
Carcinoma, Ductal, Breast
/ genetics
Carcinoma, Intraductal, Noninfiltrating
/ genetics
Carcinoma, Lobular
/ genetics
Combined Modality Therapy
Female
Follow-Up Studies
Gene Expression Profiling
Genetic Testing
/ methods
Humans
Middle Aged
Neoplasm Invasiveness
Neoplasm Recurrence, Local
/ diagnosis
Prognosis
Journal
Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840
Informations de publication
Date de publication:
Feb 2019
Feb 2019
Historique:
received:
30
07
2018
pubmed:
10
10
2018
medline:
21
5
2019
entrez:
10
10
2018
Statut:
ppublish
Résumé
Multiple synchronous ipsilateral invasive breast carcinomas (BCs) with similar histology usually have concordant receptor status. It is unknown whether individual foci with similar histology also share molecular and biological similarities or are heterogenous. This study examined the concordance of the 21-gene recurrence score (RS) in multiple synchronous morphologically similar ipsilateral BCs. We identified patients with multiple ipsilateral BCs and available RS treated at our institution from 1/2014 to 6/2018. BCs were divided into three groups based on RS: (1) RS in same risk category, (2) RS in different risk categories but within 2-unit difference (e.g., RS 17 and RS 19), and (3) RS in different risk categories and a change of > 2 units. BCs in groups 1 and 2 were considered as concordant (no significant clinical impact) and BCs in group 3 as discordant (variation affects management). A total of 53 patients met the study criteria. RS was concordant in 46 (87%) cases. Seven (13%) cases were discordant (group 3). Of these, three (43%, 3/7) had biopsy cavity changes (BXC) adjacent to the BC with highest RS. In two cases the focus with higher RS had a lower percentage of progesterone receptor-positive tumor cells. In two cases, extensive ductal carcinoma in situ was associated with the BC focus with lower RS. Morphologically similar multifocal ipsilateral BCs have concordant RS in 87% (46/53) of cases. Our results suggest that, in cases of morphologically similar multifocal BCs, testing of a single focus provides accurate prognostic and predictive information.
Sections du résumé
BACKGROUND
BACKGROUND
Multiple synchronous ipsilateral invasive breast carcinomas (BCs) with similar histology usually have concordant receptor status. It is unknown whether individual foci with similar histology also share molecular and biological similarities or are heterogenous. This study examined the concordance of the 21-gene recurrence score (RS) in multiple synchronous morphologically similar ipsilateral BCs.
PATIENTS AND METHODS
METHODS
We identified patients with multiple ipsilateral BCs and available RS treated at our institution from 1/2014 to 6/2018. BCs were divided into three groups based on RS: (1) RS in same risk category, (2) RS in different risk categories but within 2-unit difference (e.g., RS 17 and RS 19), and (3) RS in different risk categories and a change of > 2 units. BCs in groups 1 and 2 were considered as concordant (no significant clinical impact) and BCs in group 3 as discordant (variation affects management).
RESULTS
RESULTS
A total of 53 patients met the study criteria. RS was concordant in 46 (87%) cases. Seven (13%) cases were discordant (group 3). Of these, three (43%, 3/7) had biopsy cavity changes (BXC) adjacent to the BC with highest RS. In two cases the focus with higher RS had a lower percentage of progesterone receptor-positive tumor cells. In two cases, extensive ductal carcinoma in situ was associated with the BC focus with lower RS.
CONCLUSIONS
CONCLUSIONS
Morphologically similar multifocal ipsilateral BCs have concordant RS in 87% (46/53) of cases. Our results suggest that, in cases of morphologically similar multifocal BCs, testing of a single focus provides accurate prognostic and predictive information.
Identifiants
pubmed: 30298311
doi: 10.1245/s10434-018-6866-y
pii: 10.1245/s10434-018-6866-y
pmc: PMC6613395
mid: NIHMS1036270
doi:
Substances chimiques
Biomarkers, Tumor
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
329-335Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Références
Cancer. 2002 Mar 1;94(5):1383-90
pubmed: 11920492
Cancer. 2002 Apr 1;94(7):1910-6
pubmed: 11932891
N Engl J Med. 2004 Dec 30;351(27):2817-26
pubmed: 15591335
Clin Radiol. 2005 May;60(5):573-8
pubmed: 15851045
J Clin Oncol. 2006 Aug 10;24(23):3726-34
pubmed: 16720680
Clin Breast Cancer. 2006 Oct;7(4):347-50
pubmed: 17092406
Clin Chem. 2007 Jun;53(6):1084-91
pubmed: 17463177
J Clin Oncol. 2007 Oct 20;25(30):4772-8
pubmed: 17876012
J Clin Oncol. 2008 Feb 10;26(5):721-8
pubmed: 18258979
J Clin Oncol. 2008 Jul 1;26(19):3248-58
pubmed: 18474876
Arch Pathol Lab Med. 2009 Oct;133(10):1515-38
pubmed: 19792042
Cancer Invest. 2010 Nov;28(9):978-82
pubmed: 20690804
Breast Cancer Res Treat. 2012 Jan;131(2):413-24
pubmed: 21369717
Hum Pathol. 2012 Jan;43(1):48-55
pubmed: 21733550
Mod Pathol. 2012 Apr;25(4):556-66
pubmed: 22173289
Ann Oncol. 2012 Aug;23(8):2042-6
pubmed: 22219015
Appl Immunohistochem Mol Morphol. 2013 Jul;21(4):287-91
pubmed: 23060300
Breast Cancer (Auckl). 2014 Jan 09;8:1-6
pubmed: 24453493
Semin Cancer Biol. 2015 Apr;31:111-8
pubmed: 25066860
Ann Surg Oncol. 2016 Feb;23(2):471-6
pubmed: 26340863
N Engl J Med. 2015 Nov 19;373(21):2005-14
pubmed: 26412349
Hematol Oncol Stem Cell Ther. 2016 Jun;9(2):48-54
pubmed: 26808222
J Clin Oncol. 2016 Apr 1;34(10):1134-50
pubmed: 26858339
J Clin Pathol. 2017 Apr;70(4):320-326
pubmed: 27612503
Int J Breast Cancer. 2017;2017:1257078
pubmed: 28168058
CA Cancer J Clin. 2017 Jul 8;67(4):290-303
pubmed: 28294295
J Natl Compr Canc Netw. 2017 Apr;15(4):433-451
pubmed: 28404755
Am J Clin Pathol. 2017 Aug 1;148(2):167-172
pubmed: 28898988
N Engl J Med. 2018 Jul 12;379(2):111-121
pubmed: 29860917
Hum Pathol. 1995 Sep;26(9):965-9
pubmed: 7672796