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Breast Cancer Research and Treatment

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Open Access 01-04-2019 | Breast Cancer | Epidemiology

Re-testing of predictive biomarkers on surgical breast cancer specimens is clinically relevant

Authors: Stephanie Robertson, Caroline Rönnlund, Jana de Boniface, Johan Hartman

Published in: Breast Cancer Research and Treatment | Issue 3/2019

Abstract

Purpose

The accuracy of predictive and prognostic biomarker assessment in breast cancer is paramount since these guide therapy decisions. The aim was to investigate the concordance of biomarkers and immunohistochemical (IHC)-based surrogate tumor subtypes between core needle biopsies (CNB) and consecutive paired breast cancer surgical resections.

Methods

This retrospective study comprised two cohorts of patients with primary breast cancer diagnosed between 2016 and 2017: one treated with primary surgery (n = 526) and one with neoadjuvant chemotherapy (NAC) (n = 216). The agreement between preoperative CNB and paired tumor specimens regarding the assessment of biomarkers and surrogate tumor subtypes was evaluated in both cohorts.

Results

In the primary surgery cohort, the concordance rates and kappa values for estrogen receptor (ER), progesterone receptor (PR) and Ki67 were 98.6% (κ = 0.917), 89.3% (κ = 0.725) and 78.8% (κ = 0.529), respectively. Importantly, human epidermal growth factor receptor 2 (HER2) IHC assessment showed only moderate agreement (κ = 0.462). HER2 status combining IHC and in situ hybridization was discordant in 3.6% of cases, potentially impacting on indications for HER2-targeted therapy. The concordance rate for IHC-based surrogate tumor subtypes was only 73.2–78.3%. Generally lower concordance rates for ER, PR and HER2 were observed in the NAC cohort. Here, HER2 status was discordant in 7.4%.

Conclusions

The agreement of HER2 and Ki67 between CNB and paired surgical specimen in primary breast cancer is insufficient. Limited agreement of surrogate tumor subtypes indicates a significant clinical value of biomarker re-testing on surgical specimens.

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Title: Re-testing of predictive biomarkers on surgical breast cancer specimens is clinically relevant
Authors: Stephanie Robertson
Caroline Rönnlund
Jana de Boniface
Johan Hartman
Publication date: 01-04-2019
Publisher: Springer US
Keywords: Breast Cancer
Breast Cancer
Biomarkers
Published in: Breast Cancer Research and Treatment / Issue 3/2019
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-018-05119-2

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