Should liver metastases of breast cancer be biopsied to improve treatment choice?
Open Access
- 22 February 2011
- journal article
- research article
- Published by Elsevier BV in Annals of Oncology
- Vol. 22 (10), 2227-2233
- https://doi.org/10.1093/annonc/mdq751
Abstract
Background: Currently, the acquisition of tissue from metastatic deposits is not recommended as a routine practice. Our aim was to evaluate the discordance rate of estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2) receptor status between primary tumor and liver metastases and its potential impact on treatment choice. Patients and methods: We retrospectively analyzed a database including 1250 ultrasound-guided liver biopsies carried out at the European Institute of Oncology from August 1999 to March 2009. ER, PgR, and HER2 status were determined by immunohistochemistry and/or FISH. Differences between proportions were evaluated using Fisher’s exact test. Results: We identified 255 consecutive patients with matched primary and liver tissue samples. Changes in ER status were observed in 37 of 255 patients (14.5%). Changes in PgR status were observed in 124 of 255 patients (48.6%). Changes in HER2 status were observed in 24 of 172 assessable patients (13.9%). We observed a discordance in receptor status (ER, PgR, and HER2) between primary tumor and liver metastases, which led to change in therapy for 31 of 255 of patients (12.1%). Conclusions: Biopsy of metastases for reassessment of biological features should be considered in all patients, when safe and easy to carry out, since it is likely to impact treatment choice.Keywords
This publication has 34 references indexed in Scilit:
- Quantitative analysis of changes in ER, PR and HER2 expression in primary breast cancer and paired nodal metastasesAnnals of Oncology, 2010
- Genome remodelling in a basal-like breast cancer metastasis and xenograftNature, 2010
- Prognostic impact of discordance between triple-receptor measurements in primary and recurrent breast cancerAnnals Of Oncology, 2009
- Does confirmatory tumor biopsy alter the management of breast cancer patients with distant metastases?Annals Of Oncology, 2009
- Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2009Annals Of Oncology, 2009
- Immunohistochemically Determined Estrogen Receptor Phenotype Remains Stable in Recurrent and Metastatic Breast CancerAmerican Journal of Clinical Pathology, 2008
- Observer variation in immunohistochemical analysis of protein expression, time for a change?Histopathology, 2006
- Change of HER‐2/neu status in a subset of distant metastases from breast carcinomasThe Journal of Pathology, 2004
- Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implicationsProceedings of the National Academy of Sciences of the United States of America, 2001
- Estrogen and progesterone receptor content of primary and secondary breast carcinoma: Influence of time and treatmentEuropean Journal of Cancer and Clinical Oncology, 1987