Discordance in receptor status between primary and metastatic breast cancer and overall survival: A single-center analysis.

Female Humans Biomarkers, Tumor / metabolism Breast Neoplasms / pathology Neoplasm Recurrence, Local / metabolism Prognosis Receptor, ErbB-2 / metabolism Receptors, Estrogen / metabolism Receptors, Progesterone / metabolism Retrospective Studies Neoplasm Metastasis
Estrogen receptor HER2 Metastatic breast carcinoma Progesterone receptor Prognosis

Journal

Annals of diagnostic pathology
ISSN: 1532-8198
Titre abrégé: Ann Diagn Pathol
Pays: United States
ID NLM: 9800503

Informations de publication

Date de publication:
Dec 2022
Historique:
received: 11 08 2022
accepted: 03 09 2022
pubmed: 14 9 2022
medline: 30 11 2022
entrez: 13 9 2022
Statut: ppublish

Résumé

The tumor phenotype may change between primary and metastatic breast cancer. We compared the expression of estrogen receptor (ER), progesterone receptor (PR), and HER2 in a series of primary breast carcinomas (PBC) with their metastatic relapses and analyzed the impact of any changes on survival. It was a single-center retrospective study, collecting consecutive cases of metastatic breast carcinoma diagnosed in the pathology and medical oncology departments at Habib Bourguiba University Hospital in Sfax, Tunisia. An immunohistochemical study was used to assess ER, PR, and HER2 expression. Overall survival (OS) and post-metastasis survival (PMS) were evaluated using multivariable Cox regression analysis. Our study included 68 patients. ER and PR status changed in 29.4 % and 39.7 % of cases, respectively. Conversions were mainly from positive to negative status (22 % and 23.5 % for ER and PR, respectively). Differences in HER2 status were observed in 19.6 % of cases, with loss of overexpression in 6 patients (10.7 %). Adjuvant trastuzumab therapy and PBC molecular subtype (HR-, HER2+) were associated with HER2 status discordance (p = 0.02 and 0.03, respectively). On multivariable analysis, HR-negative conversion tumors were significantly associated with a worse OS (p = 0.042) and PMS (p < 0.001), compared to HR-concordant positive tumors. This study establishes that HR and HER2 status discordance between primary and metastatic breast carcinoma has a prognostic impact on patient outcome. Analyzing these receptors' status in all newly diagnosed cases of metastatic breast carcinoma is strongly recommended and would provide information for changing treatment strategies.

Sections du résumé

BACKGROUND BACKGROUND
The tumor phenotype may change between primary and metastatic breast cancer. We compared the expression of estrogen receptor (ER), progesterone receptor (PR), and HER2 in a series of primary breast carcinomas (PBC) with their metastatic relapses and analyzed the impact of any changes on survival.
MATERIALS AND METHODS METHODS
It was a single-center retrospective study, collecting consecutive cases of metastatic breast carcinoma diagnosed in the pathology and medical oncology departments at Habib Bourguiba University Hospital in Sfax, Tunisia. An immunohistochemical study was used to assess ER, PR, and HER2 expression. Overall survival (OS) and post-metastasis survival (PMS) were evaluated using multivariable Cox regression analysis.
RESULTS RESULTS
Our study included 68 patients. ER and PR status changed in 29.4 % and 39.7 % of cases, respectively. Conversions were mainly from positive to negative status (22 % and 23.5 % for ER and PR, respectively). Differences in HER2 status were observed in 19.6 % of cases, with loss of overexpression in 6 patients (10.7 %). Adjuvant trastuzumab therapy and PBC molecular subtype (HR-, HER2+) were associated with HER2 status discordance (p = 0.02 and 0.03, respectively). On multivariable analysis, HR-negative conversion tumors were significantly associated with a worse OS (p = 0.042) and PMS (p < 0.001), compared to HR-concordant positive tumors.
CONCLUSION CONCLUSIONS
This study establishes that HR and HER2 status discordance between primary and metastatic breast carcinoma has a prognostic impact on patient outcome. Analyzing these receptors' status in all newly diagnosed cases of metastatic breast carcinoma is strongly recommended and would provide information for changing treatment strategies.

Identifiants

DOI: 10.1016/j.anndiagpath.2022.152044 PMID: 36099874
pubmed: 36099874
pii: S1092-9134(22)00146-0
doi: 10.1016/j.anndiagpath.2022.152044
pii:
doi:

Substances chimiques

Biomarkers, Tumor 0
Receptor, ErbB-2 EC 2.7.10.1
Receptors, Estrogen 0
Receptors, Progesterone 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

152044

Informations de copyright

Published by Elsevier Inc.

Déclaration de conflit d'intérêts

Conflict of interest The authors have no conflicts of interest to disclose.

Auteurs

Manel Mellouli (M)

Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia. Electronic address: mellouli.manel@yahoo.fr.

Soumaya Graja (S)

Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.

Wala Ben Kridis (WB)

Department of Medical Oncology, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.

Houda Ben Ayed (HB)

Department of Community Health and Epidemiology, Hedi Chaker University Hospital, University of Sfax, Sfax, Tunisia.

Saadia Makni (S)

Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.

Meriam Triki (M)

Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.

Slim Charfi (S)

Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.

Afef Khanfir (A)

Department of Medical Oncology, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.

Tahya Sellami Boudawara (TS)

Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.

Rim Kallel (R)

Department of Pathology and Research Laboratory LR18SP10, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Discordance in receptor status between primary...
questionsmedicales.fr › Facteurs biologiques › Marqueurs biologiques › Marqueurs biologiques tumoraux › Discordance in receptor status between primary...
questionsmedicales.fr › Maladies de la peau et du tissu conjonctif › Maladies de la peau › Maladies du sein › Tumeurs du sein › Discordance in receptor status between primary...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Processus néoplasiques › Récidive tumorale locale › Discordance in receptor status between primary...
questionsmedicales.fr › Diagnostic › Pronostic › Discordance in receptor status between primary...
questionsmedicales.fr › Facteurs biologiques › Marqueurs biologiques › Marqueurs biologiques tumoraux › Récepteur ErbB-2 › Discordance in receptor status between primary...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Facteurs de transcription › Récepteurs aux stéroïdes › Récepteurs des oestrogènes › Discordance in receptor status between primary...
questionsmedicales.fr › Acides aminés, peptides et protéines › Protéines › Récepteurs cytoplasmiques et nucléaires › Récepteurs à la progestérone › Discordance in receptor status between primary...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Discordance in receptor status between primary...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Processus néoplasiques › Métastase tumorale › Discordance in receptor status between primary...