title: Comparison of immunophenotypes of primary breast carcinomas and multiple corresponding distant metastases: an autopsy study of 25 patients.
abstract: Phenotypical change in metastatic breast carcinoma has widely been accepted as an inherent biological feature rather than technical fault. We analyzed the immunohistochemical phenotype and histopathological features of 25 primary breast carcinomas and 90 corresponding distant metastases in 23 organs retrospectively. Histological slides were reviewed for prognostic and predictive factors. Overall, metastases were more similar to each other and often differed from the primary tumor. We created a 3-step grouping system based on the localization of metastases. Regions: tumors metastasizing to the abdominal region were likely to lose ER (p = 0.002); we detected loss of PR in metastases to the thorax (p = 0.039) and abdomen (p < 0.001). Organ systems: loss of ER and PR was observed in metastases to the gastrointestinal system (p = 0.026 and p = 0.001, respectively), in the respiratory system only the loss of PR was significant (p = 0.05). Individual organs: the primaries were likely to lose the hormone receptors in liver metastases (ER p = 0.026; PR p = 0.004). In lung metastases only loss of PR was apparent (p = 0.049). We did not observe significant change in HER2 status, regarding Ki67 change occurred only in bone metastases compared to the primary (p = 0.048). 7/25 patients' distant metastases had heterogeneous immunoprofiles. The later the metastasis was discovered the more likely it had a differing IHC profile compared to the primary tumor, patients who had longer OS had a higher chance to develop a discordant metastasis. Immunoprofile of metastases may differ from primary breast cancer and from each other, probably resulting in different response to therapy.
authors.affiliation: 2nd Department of Pathology, Semmelweis University, Budapest, Hungary. szekelybora@gmail.com.
authors.forename: B
authors.identifier: 0000-0002-0387-7516
authors.initials: B
authors.lastname: Szekely
authors.affiliation: 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.
authors.forename: Zs I
authors.initials: ZI
authors.lastname: Nagy
authors.affiliation: 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.
authors.forename: Zs
authors.initials: Z
authors.lastname: Farago
authors.affiliation: 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.
authors.forename: O
authors.initials: O
authors.lastname: Kiss
authors.affiliation: 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.
authors.forename: G
authors.initials: G
authors.lastname: Lotz
authors.affiliation: 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.
authors.forename: K A
authors.initials: KA
authors.lastname: Kovacs
authors.affiliation: 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.
authors.forename: L
authors.initials: L
authors.lastname: Madaras
authors.affiliation: Surgical and Molecular Tumour Pathology Centre, National Institute of Oncology, Budapest, Hungary.
authors.forename: N
authors.initials: N
authors.lastname: Udvarhelyi
authors.affiliation: Division of Oncology, Semmelweis University, Budapest, Hungary.
authors.forename: M
authors.initials: M
authors.lastname: Dank
authors.affiliation: Division of Oncology, Semmelweis University, Budapest, Hungary.
authors.forename: Gy
authors.initials: G
authors.lastname: Szentmartoni
authors.affiliation: 1st Department of Surgery, Semmelweis University, Budapest, Hungary.
authors.forename: Zs
authors.initials: Z
authors.lastname: Baranyai
authors.affiliation: 1st Department of Surgery, Semmelweis University, Budapest, Hungary.
authors.forename: L
authors.initials: L
authors.lastname: Harsanyi
authors.affiliation: 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.|MTA-SE Tumor Progression Research Group, 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.
authors.forename: A M
authors.initials: AM
authors.lastname: Tőkés
authors.affiliation: 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.
authors.forename: Jozsef
authors.initials: J
authors.lastname: Timar
authors.affiliation: 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.
authors.forename: A M
authors.initials: AM
authors.lastname: Szasz
authors.affiliation: 2nd Department of Pathology, Semmelweis University, Budapest, Hungary.
authors.forename: J
authors.initials: J
authors.lastname: Kulka
mesh_terms: D000328:Adult; D000368:Aged; D001344:Autopsy; D001859:Bone Neoplasms / Q000453:epidemiology / Q000276:immunology / Q000473:pathology* / Q000556:secondary; D001943:Breast Neoplasms / Q000453:epidemiology / Q000276:immunology / Q000473:pathology*; D002277:Carcinoma / Q000453:epidemiology / Q000276:immunology / Q000473:pathology*; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D008113:Liver Neoplasms / Q000453:epidemiology / Q000276:immunology / Q000473:pathology / Q000556:secondary; D008175:Lung Neoplasms / Q000453:epidemiology / Q000276:immunology / Q000473:pathology* / Q000556:secondary; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis
keywords: Autopsy; Breast cancer; Immunophenotype; Metastasis; Subtype; Survival