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Breast Cancer Research
Published in: Breast Cancer Research 2/2014

Open Access 01-04-2014 | Review

Biopsy confirmation of metastatic sites in breast cancer patients: clinical impact and future perspectives

Authors: Carmen Criscitiello, Fabrice André, Alastair M Thompson, Michele De Laurentiis, Angela Esposito, Lucia Gelao, Luca Fumagalli, Marzia Locatelli, Ida Minchella, Franco Orsi, Aron Goldhirsch, Giuseppe Curigliano

Published in: Breast Cancer Research | Issue 2/2014

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Abstract

Determination of hormone receptor (estrogen receptor and progesterone receptor) and human epidermal growth factor receptor 2 status in the primary tumor is clinically relevant to define breast cancer subtypes, clinical outcome, and the choice of therapy. Retrospective and prospective studies suggest that there is substantial discordance in receptor status between primary and recurrent breast cancer. Despite this evidence and current recommendations, the acquisition of tissue from metastatic deposits is not routine practice. As a consequence, therapeutic decisions for treatment in the metastatic setting are based on the features of the primary tumor. Reasons for this attitude include the invasiveness of the procedure and the unreliable outcome of biopsy, in particular for biopsies of lesions at complex visceral sites. Improvements in interventional radiology techniques mean that most metastatic sites are now accessible by minimally invasive methods, including surgery. In our opinion, since biopsies are diagnostic and changes in biological features between the primary and secondary tumors can occur, the routine biopsy of metastatic disease needs to be performed. In this review, we discuss the rationale for biopsy of suspected breast cancer metastases, review issues and caveats surrounding discordance of biomarker status between primary and metastatic tumors, and provide insights for deciding when to perform biopsy of suspected metastases and which one (s) to biopsy. We also speculate on the future translational implications for biopsy of suspected metastatic lesions in the context of clinical trials and the establishment of bio-banks of biopsy material taken from metastatic sites. We believe that such bio-banks will be important for exploring mechanisms of metastasis. In the future, advances in targeted therapy will depend on the availability of metastatic tissue.
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Metadata
Title
Biopsy confirmation of metastatic sites in breast cancer patients: clinical impact and future perspectives
Authors
Carmen Criscitiello
Fabrice André
Alastair M Thompson
Michele De Laurentiis
Angela Esposito
Lucia Gelao
Luca Fumagalli
Marzia Locatelli
Ida Minchella
Franco Orsi
Aron Goldhirsch
Giuseppe Curigliano
Publication date
01-04-2014
Publisher
BioMed Central
Published in
Breast Cancer Research / Issue 2/2014
Electronic ISSN: 1465-542X
DOI
https://doi.org/10.1186/bcr3630

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Keynote webinar | Spotlight on antibody–drug conjugates in cancer

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Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
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