Abstract
e21050 Background: Recent retrospective reviews suggest that the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor type 2 (HER2) receptor may differ between the primary and recurrence or distant metastases. In these reports, the rate of discordance for ER, PR and HER2 status ranged between 10 and 30%. Methods: Primary and recurrent tumors from 42 patients with recurrent breast cancer were studied. ER, PR, and HER2 status were determined by immunohistochemistry (IHC) and/or FISH. Results: The sites of biopsied recurrent/metastatic lesions are regional soft tissue (21.4%), lymph nodes (30.1%), lung (26.1%), bone (16.6%), brain (4.8%), and ovary (2.4%). Discordance for ER was 11% (n = 5). Among these, 7.1% (n = 3) patients had ER-positive primary tumor but ER-negative metastasis and 4.8% (n = 2) had ER-negative primary but ER-positive metastasis. Discordance for ER was 19% (n = 8). Among these, 14.3% (n = 6) had PR-positive primary but PR-negative metastasis and 4.8% (n = 2) had PR-negative primary and PR-positive metastasis. HER-2 status was known in both primary tumor and metastasis in 34 patients. Among these patients, 15.9% (n = 2) had discordant results. Among these discordant cases, two had negative primaries and positive metastasis and no cases had positive primaries and negative metastasis. Conclusions: As these discordant results make changes in treatment decision, a biopsy of the metastatic lesion could be recommended in patients with metastatic breast cancer.
Published Version
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