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  11. Discordance Of Biomarker Expression Profile Between Primary Breast Cancer And Synchronous Axillary Lymph Node Metastasis In Preoperative Core Needle Biopsy

Discordance of Biomarker Expression Profile between Primary Breast Cancer and Synchronous Axillary Lymph Node Metastasis in Preoperative Core Needle Biopsy

Stefano Marletta1,2, Alexandra Giorlandino3, Enrico Cavallo1

  • 1Division of Pathology, Humanitas Istituto Clinico Catanese, 95045 Catania, Italy.

Diagnostics (Basel, Switzerland)
|February 10, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

Biomarker expression in breast cancer (BC) primary tumors and lymph node metastases can differ significantly. These discrepancies, particularly in estrogen receptor (ER), progesterone receptor (PR), and HER2, can impact treatment decisions.

Area of Science:

  • Oncology
  • Pathology
  • Molecular Diagnostics

Background:

  • Breast cancer (BC) is a complex disease characterized by intratumoral heterogeneity.
  • This heterogeneity can lead to varied biomarker expression between primary tumors and metastases.
  • Divergent expression may affect the efficacy of chemotherapy and targeted therapies.

Purpose of the Study:

  • To investigate discrepancies in biomarker expression (ER, PR, Ki67, HER2) between matched primary breast tumors and axillary lymph node metastases.
  • To correlate these phenotypic findings with morphological features and assess their clinical impact on treatment.
  • To evaluate the utility of preoperative assessment of biomarkers in both primary tumors and lymph node metastases.

Main Methods:

  • Immunohistochemistry (IHC) and FISH analysis were performed on pre-operative core needle biopsies (CNBs) of matched primary tumors (PTs) and axillary lymph node (ALN) metastases.
Keywords:
axillary lymph node metastasesbiomarkersbreast cancerimmunohistochemistry

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  • Estrogen receptor (ER), progesterone receptor (PR), Ki67, and HER2 expression were assessed.
  • Morphological features were analyzed and correlated with biomarker expression differences.

    • Main Results:

    • Significant biomarker expression discrepancies between PTs and ALNs were observed in 10% of BC cases.
    • Differences were most notable in ER and PR staining (52%) and HER2 status (74%).
    • Approximately 90% of discrepancies correlated with morphological differences, and 39% altered treatment plans.

    Conclusions:

    • Relevant discrepancies in biomarker expression exist between primary breast tumors and metastatic lymph nodes in a notable proportion of preoperative CNBs.
    • These divergences can influence therapeutic strategies, highlighting the importance of assessing both primary tumors and metastases.
    • Routine preoperative biomarker assessment in both sites is suggested, especially when significant morphological differences are present.