Comparison of Core Needle Biopsy and Surgical Specimens in Determining Intrinsic Biological Subtypes of Breast Cancer with Immunohistochemistry.
10.4048/jbc.2017.20.3.297
- Author:
Kiho YOU
1
;
Sungmin PARK
;
Jai Min RYU
;
Isaac KIM
;
Se Kyung LEE
;
Jonghan YU
;
Seok Won KIM
;
Seok Jin NAM
;
Jeong Eon LEE
Author Information
1. Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. paojlus@hanmail.net
- Publication Type:Original Article
- Keywords:
Breast neoplasms;
Core needle biopsy;
Estrogen receptors;
Human epidermal growth factor receptor 2;
Immunohistochemistry
- MeSH:
Antibodies, Monoclonal;
Biopsy, Large-Core Needle*;
Breast Neoplasms*;
Breast*;
Diagnosis;
Estrogens;
Humans;
Immunohistochemistry*;
Methods;
Receptor, Epidermal Growth Factor;
Receptors, Estrogen;
Receptors, Progesterone
- From:Journal of Breast Cancer
2017;20(3):297-303
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We evaluated the concordance between core needle biopsy (CNB) and surgical specimens on examining intrinsic biological subtypes and receptor status, and determined the accuracy of CNB as a basic diagnostic method. METHODS: We analyzed breast cancer patients with paired CNB and surgical specimen samples during 2014. We used monoclonal antibodies for nuclear staining, and estrogen receptor (ER) and progesterone receptor (PR) status evaluation. A positive test was defined as staining greater than or equal to 1% of tumor cells. Human epidermal growth factor receptor 2 (HER2) was graded by immunohistochemistry and scored as 0 to 3+ according to the recommendations of the American Society of Clinical Oncology/College of American Pathologists. Ki-67 immunostaining was performed using the monoclonal antibody Ki-67, and the results were divided at 10% intervals. The cutoff value for high Ki-67 was defined as 20%. Concordance analysis of ER, PR, HER2, Ki-67, and five intrinsic biological subtypes was performed on CNB and surgical specimens. Statistical analysis for concordance was calculated using κ-tests. RESULTS: We found very good agreement for ER and PR with a concordance of 96.7% for ER (κ=0.903), and 94.3% for PR (κ=0.870). HER2 and Ki-67 showed concordance rates of 84.8% (κ=0.684) and 83.5% (κ=0.647), respectively, which were interpreted as good agreement. Five subgroups analysis showed 85.8% agreement and κ-value of 0.786, also indicating good agreement. CONCLUSION: CNB showed high diagnostic accuracy compared with surgical specimens, and good agreement for ER, PR, HER2, and Ki-67. Our findings reaffirmed the recommendation of CNB as an initial procedure for breast cancer diagnosis, and the assessment of receptor status and intrinsic biological subtypes to determine further treatment plans.
