Oestrogen receptor/progesterone receptor and human epidermal growth factor receptor 2 status in breast cancer: a 9-year study at Princess Noorah Oncology Center, Saudi Arabia

Estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status in invasive breast cancer: a 3,198 cases study at National Cancer Center, China

Smears from paraffin sections from 3,198 cases of surgical resection mammary carcinomas were assessed immunohistochemically for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) expressions in National Cancer Center (NCC), China, to explore the correlation of these markers to each other, to tumor histologic subtype, and to explore breast cancer four molecular subtypes clinicopathological characteristics. Pathology material of surgical resection patients presenting to NCC during July 1, 2010-July 1, 2012 were reviewed for patients' age, tumor size, subtype, grade, and ER, PR, HER2 immunohistochemistry (IHC) status. For HER2 IHC 2+ score cases, fluorescence in situ hybridization was used, as the 2007 American society of clinical oncology/college of American pathologists guidelines. There were 3,198 cases, with a median age of 51 years, a mean tumor size of 2.1 cm, and 42.3 % lymph node positivity. Of all cases, 2,506 (78.4 %) were ER+, 2,548 (79.7 %) were PR+, and 816 (25.5 %) were HER2+. Among the four molecular subtypes of breast cancer, luminal A were the majority accounting for 65.3 %, and triple-negative breast cancer accounted for 9.2 %. ER, PR, and HER2 status showed a direct correlation to tumor onset age, tumor type, and grade of ductal carcinoma. Meanwhile the four subtypes of breast cancer differed from onset age, tumor size, lymph node metastasis, and tumor grade. This study was an important documentation of Chinese breast cancer patients and the report would serve as a baseline for other future studies.

Comparison of ER/PR and HER2 statuses in primary and paired liver metastatic sites of breast carcinoma in patients with or without treatment

PURPOSE

The aim of this study was to determine whether estrogen receptor (ER)/progesterone receptor (PR) and human epidermal growth factor receptor type 2 (HER2) statuses between primary tumors and paired liver metastatic localizations of breast carcinoma were modified by treatment or during the natural metastatic process.

METHODS

ER, PR, and HER2 expressions were analyzed on paired tissue specimens taken from the primary and the liver metastatic tumors in breast cancer patients. The first group included 46 women who presented with T1-T4, N0-N3, M0 breast carcinoma when first diagnosed and were treated by neoadjuvant therapy or directly underwent surgery, then received postoperative treatment and developed liver metastasis several months/years later. The second group included 12 patients with liver metastatic breast carcinoma when first diagnosed for breast cancer. HER2 status was determined by immunohistochemistry as well as fluorescence in situ hybridization.

RESULTS

Among the 46 patients in the first group, the ER/PR and HER2 statuses (when considered as a whole histological subtype) were changed between primary tumor and liver metastatic lesions in 12 patients (26.1%). While ER and PR status were modified in 14 (30.4%) and 25 (54.3%) patients, respectively, there were only 5 (10.9%) cases showed a discrepancy in the HER2 status. In the second group, the ER/PR and HER2 statuses (when considered as a whole subtype) were consistent between primary and liver metastatic tumor in 10 of 12 (83.3%) patients. ER, PR, and HER2 statuses were modified in 0 of 12 (0%), 4 of 12 (33.3%), and 1 of 12 (8.3%) cases, respectively.

CONCLUSIONS

ER/PR and HER2 statuses between primary and liver metastatic lesions of breast carcinoma can be modified after treatment but are stable in most cases during the natural metastatic process.