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Breast Cancer
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Open Access 21-04-2024 | Breast Cancer | Original Article

Concordance of HER2 status between core needle biopsy and surgical resection specimens of breast cancer: an analysis focusing on the HER2-low status

Authors: Sei Na, Milim Kim, Yujun Park, Hyun Jung Kwon, Hee-Chul Shin, Eun-Kyu Kim, Mijung Jang, Sun Mi Kim, So Yeon Park

Published in: Breast Cancer | Issue 4/2024

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Abstract

Background

Human epidermal growth factor receptor 2 (HER2)-low status has recently gained attention because of the potential therapeutic benefits of antibody–drug conjugates (ADCs) in breast cancer patients. We aimed to investigate the concordance of HER2 status between core needle biopsy (CNB) and subsequent surgical resection specimens focusing on the HER2-low status.

Methods

This retrospective study was conducted in 1,387 patients with invasive breast cancer whose HER2 status was evaluated in both CNB and surgical resection specimens. The discordance rates between CNB and surgical resection specimens and the clinicopathological features associated with HER2 status discordance were analyzed.

Results

The overall concordance rates of HER2 status between CNB and surgical resection specimens were 99.0% (κ = 0.925) for two-group classification (negative vs. positive) and 78.5% (κ = 0.587) for three-group classification (zero vs. low vs. positive). The largest discordance occurred in CNB-HER2-zero cases with 42.8% of them reclassified as HER2-low in surgical resection. HER2 discordance was associated with lower histologic grade, tumor multiplicity, and luminal A subtype. In multivariate analysis, tumor multiplicity and estrogen receptor (ER) positivity were independent predictive factors for HER2-zero to low conversion.

Conclusions

Incorporation of HER2-low category in HER2 status interpretation reduces the concordance rate between CNB and surgical resection specimens. Tumor multiplicity and ER positivity are predictive factors for conversion from HER2-zero to HER2-low status. Therefore, HER2 status should be re-evaluated in resection specimens when considering ADCs in tumors exhibiting multiplicity and ER positivity.
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Metadata
Title
Concordance of HER2 status between core needle biopsy and surgical resection specimens of breast cancer: an analysis focusing on the HER2-low status
Authors
Sei Na
Milim Kim
Yujun Park
Hyun Jung Kwon
Hee-Chul Shin
Eun-Kyu Kim
Mijung Jang
Sun Mi Kim
So Yeon Park
Publication date
21-04-2024
Publisher
Springer Nature Singapore
Published in
Breast Cancer / Issue 4/2024
Print ISSN: 1340-6868
Electronic ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-024-01585-3

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