Concordance of Immunohistochemistry for Predictive and Prognostic Factors in Breast Cancer Between Biopsy and Surgical Excision: a Single-centre Experience and Review of the Literature

Overview

Journal Breast Cancer Res Treat

Specialty Oncology

Date 2023 Feb 21

PMID 36802316

Authors

Chiara Rossi

Sara Fraticelli

Marianna Fanizza

Alberta Ferrari

Elisa Ferraris

Alessia Messina

Angelica Della Valle

Chiara Annunziata Pasqualina Anghelone

Angioletta Lasagna

Gianpiero Rizzo

Lorenzo Perrone

Maria Grazia Sommaruga

Giulia Meloni

Silvia Dallavalle

Elisabetta Bonzano

Marco Paulli

Giuseppe Di Giulio

Adele Sgarella

Marco Lucioni

Affiliations

Soon will be listed here.

Abstract

Purpose: Accurate evaluation of breast cancer on bioptic samples is of fundamental importance to guide therapeutic decisions, especially in the neoadjuvant or metastatic setting. We aimed to assess concordance for oestrogen receptor (ER), progesterone receptor (PR), c-erbB2/HER2 and Ki-67. We also reviewed the current literature to evaluate our results in the context of the data available at present.

Methods: We included patients who underwent both biopsy and surgical resection for breast cancer at San Matteo Hospital, Pavia, Italy, between January 2014 and December 2020. ER, PR, c-erbB2, and Ki-67 immunohistochemistry concordance between biopsy and surgical specimen was evaluated. ER was further analysed to include the recently defined ER-low-positive in our analysis.

Results: We evaluated 923 patients. Concordance between biopsy and surgical specimen for ER, ER-low-positive, PR, c-erbB2 and Ki-67 was, respectively, 97.83, 47.8, 94.26, 68 and 86.13%. Cohen's κ for interobserver agreement was very good for ER and good for PR, c-erbB2 and Ki-67. Concordance was especially low (37%) in the c-erbB2 1 + category.

Conclusion: Oestrogen and progesterone receptor status can be safely assessed on preoperative samples. The results of this study advise caution in interpreting biopsy results regarding ER-low-positive, c-erbB2/HER and Ki-67 results due to a still suboptimal concordance. The low concordance for c-erbB2 1 + cases underlines the importance of further training in this area, in the light of the future therapeutic perspectives.

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