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Annals of Oncology Advance Access originally published online on July 1, 2009
Annals of Oncology 2009 20(12):1948-1952; doi:10.1093/annonc/mdp234
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

breast cancer

Discordance between core needle biopsy (CNB) and excisional biopsy (EB) for estrogen receptor (ER), progesterone receptor (PgR) and HER2 status in early breast cancer (EBC)

M. Arnedos1,*, A. Nerurkar1, P. Osin1, R. A'Hern2, I. E. Smith1 and M. Dowsett1,3

1 Breast Unit, The Royal Marsden Hospital and Institute of Cancer Research, London
2 Clinical Trials and Statistics Unit, Institute of Cancer Research, London
3 Academic Department of Biochemistry, Royal Marsden Hospital and Institute of Cancer Research, London, UK

* Correspondence to: Dr M. Arnedos, Department of Medicine, Breast Unit, The Royal Marsden Hospital, Fulham Road, London, UK. Tel: +44-2078082751; Fax: +44-2073525441; E-mail: monica.arnedos{at}rmh.nhs.uk

Background: Analysis of estrogen receptor (ER), progesterone receptor (PgR) and HER2 status in early breast cancer (EBC) is increasingly being conducted in core needle biopsies (CNBs) taken at diagnosis but the concordance with the excisional biopsy (EB) is poorly documented.

Patients and methods: Patients with EBC presenting to The Royal Marsden Hospital from June 2005 to September 2007 who had CNB and subsequent EB were included. ER and PgR were determined by immunohistochemistry (IHC) and graded from 0 to 8 (Allred score). HER2 was determined by IHC and scored from 0 to 3+. FISH analysis was carried out in HER2 2+ cases and in discordant cases.

Results: In all, 336 pairs of samples were compared. ER was positive in 253 CNBs (75%) for 255 EBs (76%) and was discordant in six patients (1.8%). PgR was positive in 221 CNBs (66%) and 227 (67.6%) EBs being discordant in 52 cases (15%). HER2 was positive in 41 (12.4%) of the 331 CNBs in which it was determined compared with 44 (13.3%) EBs and discordant in four cases (1.2%).

Conclusions: CNB can be used with confidence for ER and HER2 determination. For PgR, due to a substantial discordance between CNB and EB, results from CNB should be used with caution.

Key words: core needle biopsy, early breast cancer, estrogen receptor, HER2, progesterone receptor

Received for publication January 30, 2009. Accepted for publication March 17, 2009.


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