Hormone receptor and HER2 assessment in breast carcinoma metastatic to bone: A comparison between FNA cell blocks and decalcified core needle biopsies Journal Article

   

Authors:	Zeng, J.; Piscuoglio, S.; Aggarwal, G.; Magda, J.; Friedlander, M. A.; Murray, M.; Akram, M.; Reis-Filho, J. S.; Weigelt, B.; Edelweiss, M.
Article Title:	Hormone receptor and HER2 assessment in breast carcinoma metastatic to bone: A comparison between FNA cell blocks and decalcified core needle biopsies
Abstract:	Background: Estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) immunohistochemistry (IHC) guide the clinical management of breast cancer metastases. Decalcification of bone core needle biopsies (CNBs) can affect IHC. In the current study, the authors sought to define whether fine-needle aspiration (FNA) would be a better alternative to CNB for reliable IHC. Methods: Patients with breast cancer metastases to bone that were sampled by both CNB and FNA were selected. ER, PR, and HER2 were performed in FNA cell blocks (FNA-CBs) and concurrent decalcified CNBs. Discrepancies were classified as minor when there was a difference of up to 30% nuclear staining in IHC for ER and PR between paired samples and as major when a clinically relevant change was observed (ie, positive vs negative). Quantitative reverse transcriptase–polymerase chain reaction of ESR1 messenger RNA levels was performed on FNA/CNB pairs with discrepancies for ER IHC. IHC status of the primary breast carcinoma was recorded. Results: Concordance rates for ER, PR, and HER2 were 89%, 67%, and 93%, respectively, between FNA-CB and CNB pairs from 27 patients. Major discrepancies were noted in approximately 11% of FNA/CNB pairs for ER IHC and in 33% of FNA/CNB pairs for PR. ESR1 messenger RNA levels of FNA/CNB matched samples were similar and did not explain the differences in ER IHC expression in the majority of cases. Two of 27 FNA/CNB pairs had different results for HER2 IHC that changed from negative on CNB to equivocal (2+) on FNA-CB. Both cases had prior HER2 amplification by fluorescence in situ hybridization. Conclusions: FNA-CB and CNB appear to constitute acceptable methods for the assessment of ER, PR, and HER2 for clinical decision making. © 2019 American Cancer Society
Keywords:	immunohistochemistry; adult; clinical article; controlled study; human tissue; protein expression; aged; middle aged; human cell; case report; patient selection; bone metastasis; protein analysis; cytology; gene; gene amplification; epidermal growth factor receptor 2; histology; fluorescence in situ hybridization; breast carcinoma; needle biopsy; intermethod comparison; clinical decision making; estrogen receptor; progesterone receptor; hormone receptor; metastatic breast cancer; oncogene neu; intrarater reliability; fine needle aspiration biopsy; fine-needle aspiration; human epidermal growth factor receptor 2 (her2); human; female; priority journal; article; metastatic breast carcinoma; esr1 gene; mrna expression level; real time reverse transcription polymerase chain reaction; decalcification
Journal Title:	Cancer Cytopathology
Volume:	128
Issue:	2
ISSN:	1934-662X
Publisher:	John Wiley & Sons
Date Published:	2020-02-01
Start Page:	133
End Page:	145
Language:	English
DOI:	10.1002/cncy.22226
PUBMED:	31883437
PROVIDER:	scopus
PMCID:	PMC7027380
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85078628073&doi=10.1002%2fcncy.22226&partnerID=40&md5=51472e72c42d353f3933f74b0040fe21
Notes:	Article -- Export Date: 2 March 2020 -- Source: Scopus

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