Discordance in Biomarker Expression in Breast Cancer After Metastasis: Single Center Experience in India
PURPOSE: Biomarker—estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu) —discordance plays an essential role in the management and prognosis of patients with metastatic breast cancer. Rates of discordance have been previously reported around 12%...
Main Authors: | , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
American Society of Clinical Oncology
2019-04-01
|
Series: | Journal of Global Oncology |
Online Access: | http://ascopubs.org/doi/10.1200/JGO.18.00184 |
id |
doaj-aa0c476926524d8aa1736b94cb4ce3eb |
---|---|
record_format |
Article |
spelling |
doaj-aa0c476926524d8aa1736b94cb4ce3eb2020-11-25T03:16:53ZengAmerican Society of Clinical OncologyJournal of Global Oncology2378-95062019-04-0151810.1200/JGO.18.001841Discordance in Biomarker Expression in Breast Cancer After Metastasis: Single Center Experience in IndiaAjay Gogia0S. V. Suryanarayana Deo1Dayanand Sharma2Rakesh K. Phulia3Sanjay Thulkar4Prabhat S. Malik5Sandeep Mathur6All India Institute of Medical Science, New Delhi, IndiaAll India Institute of Medical Science, New Delhi, IndiaAll India Institute of Medical Science, New Delhi, IndiaAll India Institute of Medical Science, New Delhi, IndiaAll India Institute of Medical Science, New Delhi, IndiaAll India Institute of Medical Science, New Delhi, IndiaAll India Institute of Medical Science, New Delhi, IndiaPURPOSE: Biomarker—estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu) —discordance plays an essential role in the management and prognosis of patients with metastatic breast cancer. Rates of discordance have been previously reported around 12% to 35%, 30% to 50%, and 5% to 15%, respectively, in Western literature. Data are sparse regarding the same from developing countries, such as India. METHODS: We performed an ambispective review of paired biomarker status in patients with breast cancer—stage I, II, and III as per American Joint Committee on Cancer, 7th edition—who developed metastasis at recurrence (N = 103 patients). Biomarker status and clinical and radiologic parameters were documented at baseline and subsequent follow-up. RESULTS: Discordance was present in 21.3% for ER, 29.1% for PR, and 15.5% for HER2/neu receptor. In our cohort, 7.8% had positive to negative ER and 13.6% negative to positive. Whereas 21.4% had positive to negative PR, 7.8% had negative to positive PR. Approximately 6.8% had positive to negative HER2/neu receptor and 8.7% negative to positive. In our cohort, 41 patients (40%) had single-site metastasis—bone, 15.5%; lung, 11.7%; nonregional lymph node, 7.8%; liver, 3.9%; and brain, 0.97%. More than one site of metastasis was present in 62 patients (60%). The most common sites of metastasis were visceral—lung and liver—followed by bone, nonregional lymph node, skin, and brain. CONCLUSION: The current study demonstrated that metastatic disease evolution in breast cancer is characterized by change in the tumor biology, which leads to discordance in receptor status. Repeat biomarker studies at metastatic recurrence is warranted, especially if treatment plans include hormone and targeted therapy.http://ascopubs.org/doi/10.1200/JGO.18.00184 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ajay Gogia S. V. Suryanarayana Deo Dayanand Sharma Rakesh K. Phulia Sanjay Thulkar Prabhat S. Malik Sandeep Mathur |
spellingShingle |
Ajay Gogia S. V. Suryanarayana Deo Dayanand Sharma Rakesh K. Phulia Sanjay Thulkar Prabhat S. Malik Sandeep Mathur Discordance in Biomarker Expression in Breast Cancer After Metastasis: Single Center Experience in India Journal of Global Oncology |
author_facet |
Ajay Gogia S. V. Suryanarayana Deo Dayanand Sharma Rakesh K. Phulia Sanjay Thulkar Prabhat S. Malik Sandeep Mathur |
author_sort |
Ajay Gogia |
title |
Discordance in Biomarker Expression in Breast Cancer After Metastasis: Single Center Experience in India |
title_short |
Discordance in Biomarker Expression in Breast Cancer After Metastasis: Single Center Experience in India |
title_full |
Discordance in Biomarker Expression in Breast Cancer After Metastasis: Single Center Experience in India |
title_fullStr |
Discordance in Biomarker Expression in Breast Cancer After Metastasis: Single Center Experience in India |
title_full_unstemmed |
Discordance in Biomarker Expression in Breast Cancer After Metastasis: Single Center Experience in India |
title_sort |
discordance in biomarker expression in breast cancer after metastasis: single center experience in india |
publisher |
American Society of Clinical Oncology |
series |
Journal of Global Oncology |
issn |
2378-9506 |
publishDate |
2019-04-01 |
description |
PURPOSE: Biomarker—estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2/neu) —discordance plays an essential role in the management and prognosis of patients with metastatic breast cancer. Rates of discordance have been previously reported around 12% to 35%, 30% to 50%, and 5% to 15%, respectively, in Western literature. Data are sparse regarding the same from developing countries, such as India. METHODS: We performed an ambispective review of paired biomarker status in patients with breast cancer—stage I, II, and III as per American Joint Committee on Cancer, 7th edition—who developed metastasis at recurrence (N = 103 patients). Biomarker status and clinical and radiologic parameters were documented at baseline and subsequent follow-up. RESULTS: Discordance was present in 21.3% for ER, 29.1% for PR, and 15.5% for HER2/neu receptor. In our cohort, 7.8% had positive to negative ER and 13.6% negative to positive. Whereas 21.4% had positive to negative PR, 7.8% had negative to positive PR. Approximately 6.8% had positive to negative HER2/neu receptor and 8.7% negative to positive. In our cohort, 41 patients (40%) had single-site metastasis—bone, 15.5%; lung, 11.7%; nonregional lymph node, 7.8%; liver, 3.9%; and brain, 0.97%. More than one site of metastasis was present in 62 patients (60%). The most common sites of metastasis were visceral—lung and liver—followed by bone, nonregional lymph node, skin, and brain. CONCLUSION: The current study demonstrated that metastatic disease evolution in breast cancer is characterized by change in the tumor biology, which leads to discordance in receptor status. Repeat biomarker studies at metastatic recurrence is warranted, especially if treatment plans include hormone and targeted therapy. |
url |
http://ascopubs.org/doi/10.1200/JGO.18.00184 |
work_keys_str_mv |
AT ajaygogia discordanceinbiomarkerexpressioninbreastcanceraftermetastasissinglecenterexperienceinindia AT svsuryanarayanadeo discordanceinbiomarkerexpressioninbreastcanceraftermetastasissinglecenterexperienceinindia AT dayanandsharma discordanceinbiomarkerexpressioninbreastcanceraftermetastasissinglecenterexperienceinindia AT rakeshkphulia discordanceinbiomarkerexpressioninbreastcanceraftermetastasissinglecenterexperienceinindia AT sanjaythulkar discordanceinbiomarkerexpressioninbreastcanceraftermetastasissinglecenterexperienceinindia AT prabhatsmalik discordanceinbiomarkerexpressioninbreastcanceraftermetastasissinglecenterexperienceinindia AT sandeepmathur discordanceinbiomarkerexpressioninbreastcanceraftermetastasissinglecenterexperienceinindia |
_version_ |
1724634492326379520 |