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Published on: December 26, 2016
Receptor conversion in distant breast cancer metastases
Laurien D C Hoefnagel1, Marc J van de Vijver, Henk-Jan van Slooten
1Department of Pathology, University Medical Center Utrecht, The Netherlands.
Breast Cancer Research : BCR
|September 25, 2010
Summary
Receptor conversion in breast cancer metastases is uncommon for ERα and HER2 but more frequent for PR, particularly in liver, brain, and gastro-intestinal sites. This finding impacts systemic treatment choices for advanced breast cancer.
Area of Science:
- Oncology
- Pathology
- Genetics
Background:
- Systemic treatment for metastatic breast cancer relies on primary tumor characteristics (ERα, PR, HER2).
- Immunophenotype differences between primary tumors and metastases ('receptor conversion') can lead to suboptimal treatment.
- Previous studies on receptor conversion were limited by small sample sizes and suboptimal methods.
Purpose of the Study:
- To investigate the frequency and patterns of receptor conversion for ERα, PR, and HER2 in a large cohort of distant breast cancer metastases.
- To compare receptor status between primary tumors and their corresponding metastases using standardized IHC and ISH methods.
- To provide data that may inform clinical practice regarding treatment selection for metastatic breast cancer.
Main Methods:
- Analyzed 233 distant breast cancer metastases (skin, liver, lung, brain, GI) and their primary tumors.
- Performed immunohistochemistry (IHC) for ERα, PR, and HER2 on all samples.
- Utilized HER2 in situ hybridization (ISH) for cases with IHC conversion or equivocal results.
Main Results:
- Receptor conversion rates (10% threshold) were 10.3% for ERα and 30.0% for PR.
- HER2 conversion occurred in 5.2% of cases.
- PR conversion was significantly more frequent in liver, brain, and GI metastases compared to other sites.
Conclusions:
- Receptor conversion is a documented phenomenon in distant breast cancer metastases.
- ERα and HER2 conversion are relatively uncommon, while PR conversion is more frequent.
- The observed conversion rates, particularly for PR, highlight the need for careful consideration in selecting systemic therapy for patients with metastatic breast cancer.
