Cytologic assessment of estrogen receptor, progesterone receptor, and HER2 status in metastatic breast carcinoma

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• 作者：Fresia Pareja ; MD ; PhD^a ; Melissa P. Murray ; DO^a ; Ryan Des Jean ; MD^b ; Fumiko Konno ; MD^a ; Maria Friedlander ; MPA ; CT (ASCP)^a ; Oscar Lin ; MD ; PhD^a ; Marcia Edelweiss ; MD^a ; ^{edelweim@mskcc.org}
• 关键词：Estrogen receptor ; Progesterone receptor ; HER2 ; Cytology ; FNA ; Metastasis ; Breast cancer
• 刊名：Journal of the American Society of Cytopathology
• 出版年：2017
• 出版时间：January-February 2017
• 年：2017
• 卷：6
• 期：1
• 页码：33-40
• 全文大小：1380 K
• 卷排序：6

文摘

Discordance in the receptor status between primary breast carcinomas (PBCs) and corresponding metastasis is well documented. Interrogation of the receptor status of metastatic breast carcinoma (MBC) in cytology material is common practice, although its utility has not been thoroughly validated. We studied patients with MBC, and evaluated the concordance rates of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) between PBC surgical specimens and corresponding MBC cell blocks (CBs). We correlated the findings with clinicopathologic variables and with the fixation methods used.Materials and methodsWe searched for patients with MBC diagnosed on cytology from 2007 to 2009 and selected those with ER, PR, and HER2 tested in both the PBC surgical specimens and the MBC CBs. We included CBs fixed in formalin and methanol based solution (CytoLyt, Cytyc Corp., Boxborough, MA). All slides were reevaluated by cytopathologists. Clinical information was retrieved from the medical records.ResultsWe studied 65 patients with PBC and MBC paired specimens. The concordance rates between PBC and MBC were 78.5%, 58.5% and 96.9%, for ER, PR and HER2, respectively. When discordant, PR status switched from positive (PBC) to negative (MBC) in most cases (23/27). The PR concordance rate was 45.2% for CBs fixed in formalin and 70.6% for those fixed with CytoLyt (P = 0.047).ConclusionsThe ER, PR, and HER2 concordance rates between the PBC and MBC CBs are similar to those reported in paired surgical specimens. PR status was the most prevalent discordance and was not accompanied by a switch in ER.