Factors influencing agreement of breast cancer luminal molecular subtype by Ki67 labeling index between core needle biopsy and surgical resection specimens
| Autor: | Zsuzsanna Bago-Horvath, Martin Filipits, Günther G. Steger, Martina Mittlböck, Florian Fitzal, Thomas H. Helbich, Kristina Tendl-Schulz, Rupert Bartsch, Katja Pinker, Fabian Rössler, Peter Dubsky, Fanny Carolina Eckel, Eva-Maria Langthaler, Ulrike M Heber, Nicolas Kozakowski, Christian F. Singer, Michael Gnant, Philipp Wimmer |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Oncology medicine.medical_specialty Time Factors Receptor ErbB-2 Breast imaging Labeling index Estrogen receptor Breast Neoplasms Agreement Pathology and Forensic Medicine Breast cancer Predictive Value of Tests Risk Factors Internal medicine Biopsy Progesterone receptor medicine Humans Molecular Biology Pathological Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Reproducibility of Results Cell Biology General Medicine Middle Aged medicine.disease Immunohistochemistry Progression-Free Survival Ki-67 Antigen Receptors Estrogen Disease Progression Core needle biopsy Female Original Article Biopsy Large-Core Needle Neoplasm Grading Neoplasm Recurrence Local Tumor Suppressor Protein p53 Luminal molecular subtype Receptors Progesterone business Ki67 |
| Zdroj: | Virchows Archiv |
| ISSN: | 1432-2307 0945-6317 |
| Popis: | Reliable determination of Ki67 labeling index (Ki67-LI) on core needle biopsy (CNB) is essential for determining breast cancer molecular subtype for therapy planning. However, studies on agreement between molecular subtype and Ki67-LI between CNB and surgical resection (SR) specimens are conflicting. The present study analyzed the influence of clinicopathological and sampling-associated factors on agreement. Molecular subtype was determined visually by Ki67-LI in 484 pairs of CNB and SR specimens of invasive estrogen receptor (ER)–positive, human epidermal growth factor (HER2)–negative breast cancer. Luminal B disease was defined by Ki67-LI > 20% in SR. Correlation of molecular subtype agreement with age, menopausal status, CNB method, Breast Imaging Reporting and Data System imaging category, time between biopsies, type of surgery, and pathological tumor parameters was analyzed. Recurrence-free survival (RFS) and overall survival (OS) were analyzed using the Kaplan–Meier method. CNB had a sensitivity of 77.95% and a specificity of 80.97% for identifying luminal B tumors in CNB, compared with the final molecular subtype determination after surgery. The correlation of Ki67-LI between CNB and SR was moderate (ROC-AUC 0.8333). Specificity and sensitivity for CNB to correctly define molecular subtype of tumors according to SR were significantly associated with tumor grade, immunohistochemical progesterone receptor (PR) and p53 expression (p p = 0.22 for both). The identified factors likely mirror intratumoral heterogeneity that might compromise obtaining a representative CNB. Our results challenge the robustness of a single CNB-driven measurement of Ki67-LI to identify luminal B breast cancer of low (G1) or intermediate (G2) grade. |
| Databáze: | OpenAIRE |
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