title: Impact of host and histopathological factors on the discrepancies in estrogen receptor, and progesterone receptor, and HER2 status between core needle biopsy and surgically excised tumors.
abstract: OBJECTIVE
  The high reliability and utility of core needle biopsy (CNB) have been previously described. Our aim in this study was to clarify the host and histopathological factors influencing the discrepancies in ER, PgR, and HER2 status between CNB and surgically excised tumors (SET).
  
  
  METHODS
  All patients diagnosed with operable invasive breast cancer in our hospital between January 2005 and April 2015 were included in the study; patients who required neoadjuvant chemotherapy were excluded. ER, PgR, and HER2 expression were assessed between paired CNB and SET samples. ER and PgR status were determined using immunohistochemistry(IHC). HER2 status was determined using IHC and scored from 0 to 3+. Fluorescence in-situ hybridization analysis was carried out in HER2 2+ cases. The cut off point for ER and PgR positivity was set at 1%.
  
  
  RESULTS
  A total of 1307 patients were assessed. The concordance rates of ER, PgR, and HER2 status in CNB and SET were 95%, 84% and 97%, respectively. Factors of discrepancy were nuclear grade, histological type, and menopausal status for ER and PgR, and none detected for HER2. The discrepancy factors were assessed with univariate and multivariate analysis.
  
  
  CONCLUSIONS
  Using the largest known dataset to date of paired samples from a single institution, we evaluated the accuracy of CNB and the discrepancy factors between CNB and SET in breast cancer patients. We conclude that CNB for ER and PgR assessment in postmenopausal patients before treatment should be used with caution. Further research will contribute to increased CNB accuracy, improving patient treatment decisions.
authors.affiliation: Department of General Surgery, Chiba Cancer Center Hospital, Chiba City, Chiba, Japan. Electronic address: Rikiya@crux.ocn.ne.jp.
authors.forename: Rikiya
authors.initials: R
authors.lastname: Nakamura
authors.affiliation: Department of General Surgery, Chiba Cancer Center Hospital, Chiba City, Chiba, Japan.
authors.forename: Naohito
authors.initials: N
authors.lastname: Yamamoto
authors.affiliation: Department of General Surgery, Chiba Cancer Center Hospital, Chiba City, Chiba, Japan.
authors.forename: Nobumitsu
authors.initials: N
authors.lastname: Shiina
authors.affiliation: Department of General Surgery, Chiba Cancer Center Hospital, Chiba City, Chiba, Japan.
authors.forename: Toshiko
authors.initials: T
authors.lastname: Miyaki
authors.affiliation: Department of Clinical Pathology, Chiba Cancer Center Hospital, Chiba City, Chiba, Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Ikebe
authors.affiliation: Department of Clinical Pathology, Chiba Cancer Center Hospital, Chiba City, Chiba, Japan.
authors.forename: Makiko
authors.initials: M
authors.lastname: Itami
authors.affiliation: Department of General Surgery, Chiba University Graduate School of Medicine, Chiba City, Chiba, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Shida
authors.affiliation: Department of General Surgery, Chiba University Graduate School of Medicine, Chiba City, Chiba, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Miyazaki
mesh_terms: D000368:Aged; D062005:Biopsy, Large-Core Needle; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D017698:Postmenopause; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D011960:Receptors, Estrogen / Q000032:analysis*; D011980:Receptors, Progesterone / Q000032:analysis*; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human
keywords: Breast neoplasia; Core needle biopsy; Disease free survival; Estrogen receptor; HER2; Surgery