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Cancer and Metastasis Reviews
Published in: Cancer and Metastasis Reviews 3/2016

01-09-2016 | CLINICAL

Estrogen, progesterone, and HER2/neu receptor discordance between primary and metastatic breast tumours—a review

Authors: C. Yeung, J. Hilton, M. Clemons, S. Mazzarello, B. Hutton, F. Haggar, C. L. Addison, I. Kuchuk, X. Zhu, K. Gelmon, A. Arnaout

Published in: Cancer and Metastasis Reviews | Issue 3/2016

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Abstract

Discordance in estrogen (ER), progesterone (PR), and HER2/neu status between primary breast tumours and metastatic disease is well recognized. In this review, we highlight how receptor discordance between primary tumours and paired metastasis can help elucidate the mechanism of metastasis but can also effect patient management and the design of future trials. Discordance rates and ranges were available from 47 studies (3384 matched primary and metastatic pairs) reporting ER, PR, and HER2/neu expression for both primary and metastatic sites. Median discordance rates for ER, PR, and HER2/neu were 14 % (range 0–67 %, IQR 9–25 %), 21 % (range 0–62 %, IQR 15–41 %), and 10 % (range 0–44 %, IQR 4–17 %), respectively. Loss of receptor expression was more common (9.17 %) than gain (4.51 %). Discordance rates varied amongst site of metastasis with ER discordance being highest in bone metastases suggesting that discordance is a true biological phenomenon. Discordance rates vary for both the biomarker and the metastatic site. Loss of expression is more common than gain. This can affect patient management as it can lead to a reduction in both the efficacy and availability of potential therapeutic agents. Future studies are recommended to explore both the mechanisms of discordance as well as its impact on patient outcome and management.
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Metadata
Title
Estrogen, progesterone, and HER2/neu receptor discordance between primary and metastatic breast tumours—a review
Authors
C. Yeung
J. Hilton
M. Clemons
S. Mazzarello
B. Hutton
F. Haggar
C. L. Addison
I. Kuchuk
X. Zhu
K. Gelmon
A. Arnaout
Publication date
01-09-2016
Publisher
Springer US
Published in
Cancer and Metastasis Reviews / Issue 3/2016
Print ISSN: 0167-7659
Electronic ISSN: 1573-7233
DOI
https://doi.org/10.1007/s10555-016-9631-3

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