Multifocal/multicentric ipsilateral invasive breast carcinomas with similar histology: Is multigene testing of all individual foci necessary? Journal Article


Authors: Grabenstetter, A.; Brogi, E.; Chou, J. F.; Morrow, M.; Dickler, M.; Norton, L.; Wen, H. Y.
Article Title: Multifocal/multicentric ipsilateral invasive breast carcinomas with similar histology: Is multigene testing of all individual foci necessary?
Abstract: Background: Multiple synchronous ipsilateral invasive breast carcinomas (BCs) with similar histology usually have concordant receptor status. It is unknown whether individual foci with similar histology also share molecular and biological similarities or are heterogenous. This study examined the concordance of the 21-gene recurrence score (RS) in multiple synchronous morphologically similar ipsilateral BCs. Patients and Methods: We identified patients with multiple ipsilateral BCs and available RS treated at our institution from 1/2014 to 6/2018. BCs were divided into three groups based on RS: (1) RS in same risk category, (2) RS in different risk categories but within 2-unit difference (e.g., RS 17 and RS 19), and (3) RS in different risk categories and a change of > 2 units. BCs in groups 1 and 2 were considered as concordant (no significant clinical impact) and BCs in group 3 as discordant (variation affects management). Results: A total of 53 patients met the study criteria. RS was concordant in 46 (87%) cases. Seven (13%) cases were discordant (group 3). Of these, three (43%, 3/7) had biopsy cavity changes (BXC) adjacent to the BC with highest RS. In two cases the focus with higher RS had a lower percentage of progesterone receptor-positive tumor cells. In two cases, extensive ductal carcinoma in situ was associated with the BC focus with lower RS. Conclusions: Morphologically similar multifocal ipsilateral BCs have concordant RS in 87% (46/53) of cases. Our results suggest that, in cases of morphologically similar multifocal BCs, testing of a single focus provides accurate prognostic and predictive information. © 2018, Society of Surgical Oncology.
Journal Title: Annals of Surgical Oncology
Volume: 26
Issue: 2
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2019-02-01
Start Page: 329
End Page: 335
Language: English
DOI: 10.1245/s10434-018-6866-y
PUBMED: 30298311
PROVIDER: scopus
PMCID: PMC6613395
DOI/URL:
Notes: Export Date: 1 February 2019 -- Source: Scopus
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MSK Authors
  1. Joanne Fu-Lou Chou
    333 Chou
  2. Monica Morrow
    773 Morrow
  3. Larry Norton
    760 Norton
  4. Hannah Yong Wen
    305 Wen
  5. Edi Brogi
    519 Brogi