Benefits of using the cell block method to determine the discordance of the HR/HER2 expression in patients with metastatic breast ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-05-13

AUTHORS

Yuko Nakayama, Hiroshi Nakagomi, Masato Omori, Masayuki Inoue, Kazunori Takahashi, Masahiro Maruyama, Atsushi Takano, Kazushige Furuya, Kenji Amemiya, Eri Ishii, Toshio Oyama

ABSTRACT

BackgroundThe discordance of the hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2) expressions between primary cancer and metastatic lesions is an important issue when selecting the optimal treatments for patients with metastatic breast cancer. A rebiopsy for the metastatic cancer is recommended before selecting the treatment; however, it is not easy to take a tissue sample for all metastatic lesions. Fine needle aspiration cytology (FNA) for regional lymph nodes and aspiration for pleural effusions or ascites are less invasive procedures to obtain the necessary samples to examine the HR/HER2 expression. These cytologic materials are able to be stained as a tissue sample using the cell block method.PatientsWe examined the HR/HER2 expression of 20 patients with breast cancer (8 with synchronous metastases and 12 with metachronous metastases) using the cell block method. Among 8 patients with synchronous metastases, 7 patients with axillary lymph node (LN) metastasis were examined by fine needle aspiration (FNA), and one patient with pleural metastases was analyzed for the aspirated fluid. While in 12 patients with metachronous metastases, 7 patients were examined for their pleural effusion, 3 patients were examined for regional lymph node metastases, and 1 patient were examined for aspirated ascites. We compared the HR/HER expression between primary cancer and metastatic lesion in 17 patients (5 cases of 8 synchronous metastases, and all of 12 metachronous metastases).ResultsDiscordance of HR was seen in 4 of 17 patients (24 %). Three cases with axillary LN metastasis (2 cases with synchronous metastases and one with metachronous metastasis) showed negative change of ER. Negative change of HER2 expression was seen in one patient with ascites caused by peritoneal dissemination.ConclusionsCytology materials are easily obtained by FNA for LN metastases and aspiration for malignant effusions and analyzed for HR/HER2 expression using cell block method. We should take advantage of cell block analysis to determine the discordance of the HR/HER2 expression to select the optimal treatment for metastatic breast cancer. More... »

PAGES

633-639

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12282-015-0615-x

DOI

http://dx.doi.org/10.1007/s12282-015-0615-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1030632813

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25968348


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48 benefits
49 block analysis
50 block method
51 breast cancer
52 cancer
53 cases
54 cell block analysis
55 cell block method
56 changes
57 cytologic material
58 cytology
59 discordance
60 dissemination
61 effusion
62 epidermal growth factor receptor 2 (HER2) expression
63 expression
64 factor receptor 2 (HER2) expressions
65 fine needle aspiration
66 fine needle aspiration cytology
67 fluid
68 growth factor receptor 2 (HER2) expressions
69 hormone receptors
70 hr/
71 human epidermal growth factor receptor 2 (HER2) expression
72 important issue
73 invasive procedures
74 issues
75 lesions
76 lymph node metastasis
77 lymph nodes
78 malignant effusions
79 materials
80 metachronous metastases
81 metastasis
82 metastatic breast cancer
83 metastatic cancer
84 metastatic lesions
85 method
86 necessary samples
87 needle aspiration
88 needle aspiration cytology
89 negative changes
90 node metastasis
91 nodes
92 optimal treatment
93 patients
94 peritoneal dissemination
95 pleural effusion
96 pleural metastasis
97 primary cancer
98 procedure
99 rebiopsy
100 receptor 2 expression
101 receptors
102 regional lymph node metastasis
103 regional lymph nodes
104 samples
105 synchronous metastases
106 tissue samples
107 treatment
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