title: HER-2, ER, PR status concordance in primary breast cancer and corresponding metastatic lesion in lymph node in Chinese women.
abstract: OBJECTIVE
  To compare the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) in the primary site and the metastatic lesion of lymph nodes in invasive breast cancer for investigating whether the expression of these biomarkers in the primary site could act as a surrogate to the lymphatic metastatic lesion in the same patient.
  
  
  METHODS
  In lymphatic metastatic lesion and corresponding primary lesion of 107 cases of invasive breast cancer, ER and PR statuses were assessed by immunohistochemistry (IHC). HER-2 expression level was evaluated by IHC and/or fluorescence in situ hybridization (FISH).
  
  
  RESULTS
  In the primary lesions, 43.9% were ER positive; 46.7% were PR positive; 34.6% were HER-2 positive. In corresponding lymphatic metastatic lesions, the HER-2 status was concordant in 90 patients; 9 patients were diagnosed positive in metastatic lesion while negative in primary lesion; 8 patients were negative in metastatic lesion while positive in primary site (agreement, 84.1%; κ=0.647). A change in ER status was observed in 24 cases: 17 cases positive in metastatic site while negative in primary site; 7 cases negative in metastatic site while positive in primary site (agreement, 77.6%; κ=0.534). PR status discordance between the primary lesion and the metastatic regional lymph nodes was reported in 19 cases (agreement, 82.2%; κ=0.640).
  
  
  CONCLUSIONS
  This study revealed that there was only a moderate concordance of ER, PR and HER-2 status between primary tumors and metastatic lymph nodes. These results indicate that it was inappropriate to predict the status of ER, PR and HER-2 in metastatic lymph nodes based on the results of evaluation of that in primary lesions.
authors.affiliation: Department of Pathology, Shaoxing People's Hospital & Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang, China.
authors.forename: Min Hua
authors.initials: MH
authors.lastname: Li
authors.affiliation: Department of Pathology, Shaoxing People's Hospital & Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang, China.
authors.forename: Chuan Ling
authors.initials: CL
authors.lastname: Hou
authors.affiliation: Department of Pathology, Shaoxing People's Hospital & Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang, China.
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Pathology, School of Medicine, Shaoxing University, Shaoxing, Zhejiang, China. Electronic address: minhuali19810816@163.com.
authors.forename: Ai Jing
authors.initials: AJ
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D014408:Biomarkers, Tumor / Q000032:analysis*; D001943:Breast Neoplasms / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008207:Lymphatic Metastasis / Q000473:pathology*; D008875:Middle Aged; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis / Q000096:biosynthesis; D011960:Receptors, Estrogen / Q000032:analysis / Q000096:biosynthesis; D011980:Receptors, Progesterone / Q000032:analysis / Q000096:biosynthesis; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human
keywords: Breast cancer; ER; HER-2; Metastatic lymph nodes; PR