Clinicopathologic features of unexpectedly HER2 positive breast carcinomas: An institutional experience
| Autor: | Lauren Rosen, Kalliopi P. Siziopikou, Luis Z. Blanco, Carissa Laboy, Jennifer L. Pincus |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Adult Pathology medicine.medical_specialty Receptor ErbB-2 Population Breast Neoplasms Pathology and Forensic Medicine 03 medical and health sciences 0302 clinical medicine Trastuzumab medicine Recurrent disease Biomarkers Tumor Humans skin and connective tissue diseases education Human Epidermal Growth Factor Receptor 2 Lymph node Aged 80 and over education.field_of_study Invasive carcinoma business.industry Carcinoma Ductal Breast Gene Amplification Cell Biology Middle Aged Prognosis 030104 developmental biology medicine.anatomical_structure 030220 oncology & carcinogenesis Lymphatic Metastasis Immunohistochemistry Neoplasm Recurrence Local Breast carcinoma business medicine.drug |
| Zdroj: | Pathology, research and practice. 222 |
| ISSN: | 1618-0631 |
| Popis: | Human epidermal growth factor receptor 2 (HER2) overexpression occurs in 15-20 % of all breast carcinomas. These tumors are usually high-grade which often correlates with reduced overall survival and increased rates of recurrence. In a retrospective review, we identified 19 cases of unexpectedly HER2 positive (by immunohistochemistry and/or fluorescence in-situ hybridization) invasive breast carcinomas on core needle biopsies from a registry at Northwestern Memorial Hospital. These cases included low-grade tumors, invasive lobular carcinomas, classic type, and invasive carcinomas with special subtype features. Twelve of the tumors were histologic grade 1 and 7 were histologic grade 2. One of the grade 1 tumors had tubular features (8 %), 1 had cribriform features (8 %), 2 had mucinous features (17 %), 2 were invasive lobular carcinomas, classic type (17 %), and the rest were invasive carcinoma, no special type (50 %). The histologic grade 2 tumors included 5 invasive lobular carcinomas, classic type (71 %) and 2 invasive ductal carcinomas with mucinous features (29 %). By immunohistochemistry, 13 (65 %) were HER2 score 3+, 7 were score 2+ (35 %), and reflex fluorescence in-situ hybridization (FISH) testing showed amplification in 6 cases, with 1 equivocal case amplified on excision. Despite the HER2 positive status in the selected cases, no unique morphologic features that would indicate aggressive behavior were identified. In clinical follow up, two patients were found to have recurrences, five had lymph node metastasis, and one had distant metastasis. None of the patients with recurrent disease were treated with trastuzumab, despite their positive HER2 results. These findings support that our population of HER2 positive carcinomas showed a similar rate of lymph node metastases and recurrence as poorly-differentiated tumors, supporting HER2 positivity as a poor prognostic indicator, irrespective of morphologic features. We recommend continuing to test all breast cancers, regardless of grade or special subtype features, to provide the most comprehensive treatment and prognostic information for both clinicians and patients. |
| Databáze: | OpenAIRE |
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