Identifying breast cancer patients who require a double-check of preoperative core needle biopsy and postoperative surgical specimens to determine the molecular subtype of their tumor
10.4174/astr.2019.97.5.223
- Author:
Je Hyung PARK
1
;
Hyun Yul KIM
;
Youn Joo JUNG
;
Dong Il KIM
;
Jee Yeon KIM
;
Hyun June PAIK
Author Information
1. Department of Surgery, Pusan National University Yangsan Hospital, Yangsan, Korea. hjpaik80@naver.com
- Publication Type:Original Article
- Keywords:
Adjuvant;
Biopsy;
Breast neoplasms;
Chemotherapy;
Immunohistochemistry;
Large-core needle
- MeSH:
Biopsy;
Biopsy, Large-Core Needle;
Breast Neoplasms;
Breast;
Busan;
Diagnosis;
Drug Therapy;
Epidermal Growth Factor;
Gyeongsangnam-do;
Humans;
Immunohistochemistry;
Medical Records;
Obesity;
Odds Ratio
- From:Annals of Surgical Treatment and Research
2019;97(5):223-229
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Core needle biopsy (CNB) is a widely used procedure for breast cancer diagnosis and analyzing results of immunohistochemistry (IHC). Several studies have shown concordance or discordance in IHC results between CNB and surgical specimens (SS). A double-check (CNB and SS) is inefficient and costly to perform a double-check on all patients. Therefore, it is important to determine which patients would benefit from a double-check. METHODS: We collected the medical records of patients who underwent breast cancer surgery at Pusan National University Yangsan Hospital between April 2009 and June 2018 (n = 620). Molecular subtypes were classified as follows by hormone receptors (HR) and human epidermal growth factor receptor-2 (HER2): HR+/HER2+, HR+/HER2−, HR−/HER2+, HR−/HER2−. Clinicopathological factors including age, obesity, histological grade, preoperative CEA, CA15-3, T stage, N stage, and menopausal status were assessed to determine whether they were associated with subtype change. RESULTS: Increasing histological grade (P < 0.001; odds ratio [OR], 3.693; 95% confidence interval [CI], 1.941–7.025), preoperative CEA ≥ 5 ng/mL (P =0.042; OR, 2.399; 95% CI, 1.009–5.707) and higher T stage (P = 0.015; OR, 2.241; 95% CI, 1.152–4.357) were significantly associated with subtype change. On multivariable analyses, subtype changes were more common in high-grade breast cancer (P < 0.001; OR, 1.077; 95% CI, 1.031–1.113) and CEA ≥ 5 (P = 0.032; OR, 2.658; 95% CI, 1.088–6.490). CONCLUSION: Patients with moderate- to high-grade tumors or CEA ≥ 5 ng/mL are required a double-check to determine the molecular subtype of breast cancer.
