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Discordances in ER, PR and HER2 receptors between primary and recurrent/metastatic lesions and their impact on survival in breast cancer patients

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Abstract

The aim of this study was to evaluate the frequency and prognostic impact of changes in the estrogen (ER), progesterone (PR) and human epidermal growth factor receptor 2 (HER2) status between primary and recurrent/metastatic lesions (RML). We investigated 133 breast cancer patients for ER, PR and HER2 status of primary and RML and their follow-up records. Among 133 patients with RML, discordance rate for ER, PR, and HER2 was 18.8, 33.8, and 6.8 %, respectively. ER, PR and HER2 discordance were observed in 20.0, 38.1 and 6.7 % of the patients with distant metastasis, and in 14.3, 17.9 and 7.1 % of the patients with locoregional recurrence. The mean time between the primary diagnosis and last contact or death was 57 (range 22–78) months and between the recurrence biopsy and last contact or death was 17 (range 1–33) months. Among 133 patients with RML, the ER-discordant cases and ER-loss cases experienced a worse overall survival (OS) (p = 0.001 and p = 0.016, respectively) and post-recurrence survival (PRS) (p = 0.001 and p = 0.018, respectively), compared with the respective concordant cases. The HER2-discordant patients and HER2-loss patients had a poorer OS (p = 0.008 and p = 0.001, respectively) and PRS (p = 0.004 and p = 0.000, respectively) than the respective concordant cases. Among 105 patients with distant metastasis, ER discordance, ER loss, HER2 discordance and HER2 loss, compared with the respective concordant cases, resulted in a worse OS and PRS (p < 0.05 for all). Our findings show an evident change in ER, PR and HER2 between breast primary tumors and relapsing tumors. The unstable status for ER or HER2 in breast cancer seems to be clinically significant and to correlate with a worse prognosis.

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Acknowledgments

The authors acknowledge the financial support from the National Natural Science Foundation of China.

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The authors have no conflict of interest.

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Authors and Affiliations

  1. Department of Pathology, The Third People’s Hospital of Dongguan City, Dongguan, Guangdong Province, China

    Yu-Feng Yang, Shu-Rui Xie & Yan-Fang Xie

  2. Department of Surgical Oncology, The Affiliated Tumor Hospital of Guangxi Medical University, 71 He-di Road, Nanning, 530021, Guangxi Province, China

    Ying-Yang Liao & Ning-Fu Peng

  3. Department of Surgical Oncology, The Third People’s Hospital of Dongguan City, Dongguan, Guangdong Province, China

    Mei Yang

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  1. Yu-Feng Yang
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Correspondence to Ning-Fu Peng.

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Yang, YF., Liao, YY., Yang, M. et al. Discordances in ER, PR and HER2 receptors between primary and recurrent/metastatic lesions and their impact on survival in breast cancer patients. Med Oncol 31, 214 (2014). https://doi.org/10.1007/s12032-014-0214-2

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