Should liver metastases of breast cancer be biopsied to improve treatment choice?

被引:96
作者
Curigliano, G. [1 ]
Bagnardi, V. [2 ,3 ,4 ]
Viale, G. [5 ,6 ]
Fumagalli, L. [1 ]
Rotmensz, N. [2 ]
Aurilio, G. [1 ]
Locatelli, M. [1 ]
Pruneri, G. [5 ,6 ]
Giudici, S. [1 ]
Bellomi, M. [6 ,7 ]
Della Vigna, P. [7 ]
Monfardini, L. [7 ]
Orsi, F. [7 ]
Nole, F. [1 ]
Munzone, E. [1 ]
Goldhirsch, A. [1 ]
机构
[1] Ist Europeo Oncol, Div Med Oncol, Dept Med, I-20141 Milan, Italy
[2] Ist Europeo Oncol, Div Epidemiol & Biostat, I-20141 Milan, Italy
[3] Univ Milano Bicocca, Dept Stat, Milan, Italy
[4] Frontier Sci & Technol Res Fdn Inc, So Europe, Chiasso, Switzerland
[5] Ist Europeo Oncol, Div Pathol, I-20141 Milan, Italy
[6] Univ Milan, Sch Med, Milan, Italy
[7] Ist Europeo Oncol, Div Radiol, I-20141 Milan, Italy
关键词
biology of disease; biopsy; breast cancer; liver metastasis; ESTROGEN-RECEPTOR; DISTANT METASTASES; PROTEIN EXPRESSION; SCORING SYSTEMS; LYMPH-NODES; RECURRENT; TIME; CARCINOMAS; THERAPY; LESIONS;
D O I
10.1093/annonc/mdq751
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Currently, the acquisition of tissue from metastatic deposits is not recommended as a routine practice. Our aim was to evaluate the discordance rate of estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2) receptor status between primary tumor and liver metastases and its potential impact on treatment choice. Patients and methods: We retrospectively analyzed a database including 1250 ultrasound-guided liver biopsies carried out at the European Institute of Oncology from August 1999 to March 2009. ER, PgR, and HER2 status were determined by immunohistochemistry and/or FISH. Differences between proportions were evaluated using Fisher's exact test. Results: We identified 255 consecutive patients with matched primary and liver tissue samples. Changes in ER status were observed in 37 of 255 patients (14.5%). Changes in PgR status were observed in 124 of 255 patients (48.6%). Changes in HER2 status were observed in 24 of 172 assessable patients (13.9%). We observed a discordance in receptor status (ER, PgR, and HER2) between primary tumor and liver metastases, which led to change in therapy for 31 of 255 of patients (12.1%). Conclusions: Biopsy of metastases for reassessment of biological features should be considered in all patients, when safe and easy to carry out, since it is likely to impact treatment choice.
引用
收藏
页码:2227 / 2233
页数:7
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