Publication: Whether to determine HER2 status for breast cancer in the primary tumour or in the metastasis
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Date
2009
Authors
Santiago, M.P. ; Vázquez-Boquete, A. ; Fernández, B. ; Masa, C. ; Antúnez, Jose R. ; Fraga, M. ; Forteza, J. ; Garcia-Caballero, Tomas
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Publisher
Murcia : F. Hernández
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DOI
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info:eu-repo/semantics/article
Description
Abstract
Trastuzumab has substantially changed the
prognosis of breast carcinomas. As HER2 overexpression/
amplification is a prerequisite for treatment
with trastuzumab, an accurate assessment of HER-2
status is the first step for successful treatment. In
metastatic breast cancer, we routinely assess HER2
expression in the primary tumour, assuming that HER2
status remains stable through cancer progression.
However, it is frequent to find reports that describe
discordance between HER2 expression in primary and
metastatic tumours. The aim of this paper was to verify
whether HER2 status of breast carcinomas is maintained
in the corresponding axillary metastasis. Immunohistochemistry
was performed on 52 breast carcinomas
and their matched axillary metastasis. HercepTest results
were concordant in 46 out of 52 cases (88.5%). FISH
proved that the differences observed were clinically
relevant in only one of the 52 cases studied (98%
concordance). We concluded that HER2 status was
stable during axillary metastatic progression. Evaluation
of gene HER2 status in axillary metastasis rather than in
the primary can be useful in certain situations, e.g., small
invasive component intimately mixed with in situ
component and difficult to recognize in dark field, no tumor after biopsy, or axillary relapse (in this case we
can find occasional de novo amplifications susceptible to
trastuzumab treatment).
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