title: Reliability of Prognostic and Predictive Factors Evaluated by Needle Core Biopsies of Large Breast Invasive Tumors.
abstract: OBJECTIVE
  Preoperative biopsy of breast cancer allows for prognostic/predictive marker assessment. However, large tumors, which are the main candidates for preoperative chemotherapy, are potentially more heterogeneous than smaller ones, which questions the reliability of histologic analyses of needle core biopsy (NCB) specimens compared with whole surgical specimens (WSS). We studied the histologic concordance between NCB specimens and WSS in tumors larger than 2 cm.
  
  
  METHODS
  Early pT2 or higher breast cancers diagnosed between 2008 and 2011 in our center, with no preoperative treatments, were retrospectively screened. We assessed the main prognostic and predictive validated parameters. Comparisons were performed using the κ test.
  
  
  RESULTS
  In total, 163 matched NCB specimens and WSS were analyzed. The correlation was excellent for ER and HER2 (κ = 0.94 and 0.91, respectively), moderate for PR (κ = 0.79) and histologic type (κ = 0.74), weak for Ki-67 (κ = 0.55), and minimal for SBR grade (κ = 0.29). Three of the 21 HER2-positive cases (14% of HER2-positive patients or 1.8% of all patients), by WSS analysis, were initially negative on NCB specimens even after chromogenic in situ hybridization.
  
  
  CONCLUSIONS
  NCB for large breast tumors allowed reliable determination of ER/PR expression. However, the SBR grade may be deeply underestimated, and false-negative evaluation of the HER2 status would have led to a detrimental lack of trastuzumab administration.
authors.affiliation: From the Department of Medical Oncology, camillepetrau@yahoo.fr.
authors.forename: Camille
authors.initials: C
authors.lastname: Petrau
authors.affiliation: From the Department of Medical Oncology, INSERM U918.
authors.forename: Florian
authors.initials: F
authors.lastname: Clatot
authors.affiliation: Department of Pathology.
authors.forename: Marie
authors.initials: M
authors.lastname: Cornic
authors.affiliation: Department of Pathology.
authors.forename: Anca
authors.initials: A
authors.lastname: Berghian
authors.affiliation: Department of Pathology.
authors.forename: Liana
authors.initials: L
authors.lastname: Veresezan
authors.affiliation: Department of Radiology, and.
authors.forename: Françoise
authors.initials: F
authors.lastname: Callonnec
authors.affiliation: Department of Surgery, Centre Henri Becquerel, Rouen, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Baron
authors.affiliation: From the Department of Medical Oncology.
authors.forename: Corinne
authors.initials: C
authors.lastname: Veyret
authors.affiliation: Department of Pathology.
authors.forename: Sophie
authors.initials: S
authors.lastname: Laberge
authors.affiliation: From the Department of Medical Oncology.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Thery
authors.affiliation: INSERM U918, Department of Pathology.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Picquenot
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis*; D062005:Biopsy, Large-Core Needle; D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D060787:Neoplasm Grading / Q000379:methods; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000096:biosynthesis*; D011960:Receptors, Estrogen / Q000096:biosynthesis; D011980:Receptors, Progesterone / Q000096:biosynthesis; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human
keywords: Biopsy; Breast neoplasms; Early diagnosis; Large-core needle; Neoadjuvant therapy