Estrogen and HER-2 Receptor Discordance Between Primary Breast Cancer and Metastasis.
Discordance in estrogen receptor and human epidermal growth factor receptor 2 receptor status between the primary tumor and recurrence is frequently reported in the literature. This is frequently interpreted as evidence for a change in the biology of breast cancer during the course of the disease. T...
| Publicado en: | Oncologist Vol. 15; no. 11; pp. 1164 - 1169 |
|---|---|
| Autores principales: | , , , |
| Formato: | equations & formulas tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Nov2010
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104814894&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104814894 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10837159 IJ7 jtl: Oncologist issn: 10837159 maglogo: N pubinfo: dt: Nov2010 vid: 15 iid: 11 pid: 622 pub: Oxford University Press / USA artinfo: ui: 104814894 58057641 10.1634/theoncologist.2010-0059 NLM21041379 104814894 ppf: 1164 ppct: 5 formats: tig: atl: Estrogen and HER-2 Receptor Discordance Between Primary Breast Cancer and Metastasis. aug: au: Pusztai, Lajos Viale, Giuseppe Kelly, Catherine M. Hudis, Clifford A. affil: Department of Breast Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA; Department of Pathology, Istituto Europeo di Oncologia e Università degli Studi di Milano, Milan, Italy; Department of Breast Medical Oncology, University of Texas M.D. Anderson Cancer Center, Houston, Texas, USA; Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA sug: subj: Breast Neoplasms Pathology Neoplasm Metastasis Pathology Receptors, Cell Surface Analysis HER-2-neu Oncogene Biopsy Diagnosis, Laboratory Methods False Negative Results False Positive Results ab: Discordance in estrogen receptor and human epidermal growth factor receptor 2 receptor status between the primary tumor and recurrence is frequently reported in the literature. This is frequently interpreted as evidence for a change in the biology of breast cancer during the course of the disease. This commentary discusses some of the caveats of this interpretation. Discordant receptor results can be caused by any of 3 factors: (a) a genuine switch in the biology of the disease, (b) sampling error in focally receptor-positive cancers, and (c) limited accuracy and reproducibility of receptor assays. The relative contribution of each of these factors to discordant results is unknown. A switch in molecular class between primary and recurrent cancer (or residual cancer after therapy) appears to be a rare event based on the available limited molecular profiling data. Small pockets of strongly focally receptor-positive tumor nests in a larger receptor-negative cancer are also relatively infrequently seen. Discordance resulting from inherent limitations in assay reproducibility is evident from the frequently discordant receptor results even when the same samples are assessed in different laboratories (e.g., central versus local laboratory). A repeat tumor biopsy is clearly justified when it is suspected, on clinical grounds, that the original receptor results may have been false negative or when the diagnosis of metastatic disease is in question. However, routine repeat biopsy for receptor re-evaluation does not necessarily improve diagnostic accuracy and have a potential to harm through a false-negative result. For patients with clinical courses consistent with hormone responsiveness, or with prior positive hormone receptor results, a course of endocrine therapy is reasonable regardless of the most recent hormone receptor assay result. pubtype: Academic Journal doctype: equations & formulas tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|