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Prognostic markers in breast cancer: the reliability of HER2/neu status in core needle biopsy of 325 patients with primary breast cancer

Prognostische Marker beim Mammakarzinom: die Zuverlässigkeit der HER2/neu-Bestimmung in der Nadelbiopsie bei 325 Patientinnen mit primärem Mammakarzinom

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Zusammenfassung

Hintergrund

Die Bestimmung einer HER2/neu-Überexpression im Gewebe eines Mammakarzinoms gibt Aufschluss über einen wichtigen prognostischen und prädiktiven Marker. Eine Überexpression von HER2/neu ist beim Mammakarzinom mit einer schlechten Prognose assoziiert. Da die Nadelbiopsie zunehmend in der Diagnostik des Mammakarzinoms angewandt wird, war es unser Ziel die Zuverlässigkeit der HER2/neu-Bestimmung in der Nadelbiopsie bei Patientinnen mit primärem Mammakarzinom zu evaluieren.

Patienten und Methoden

Wir untersuchten an 325 Patientinnen mit primärem Mammakarzinom die Genauigkeit der immunhistochemischen HER2/neu-Bestimmung in der Nadelbiopsie verglichen mit dem Operationspräparat. Bei Patientinnen mit stark positivem HER2/neu Status wurde zusätzlich eine Fluoreszenz in situ Hybridisierung (FISH) der Nadelbiopsie durchgeführt.

Ergebnisse

Die Genauigkeit der HER2/neu-Bestimmung in der Nadelbiopsie verglichen mit dem Operationspräparat durch Immunhistochemie alleine war 92% und konnte durch zusätzliche FISH Analyse auf 96% und werden (gewichteter Kappa Koeffizient: 0,86).

Diskussion

Wir konnten an diesem großen Patientenkollektiv zeigen, dass die Bestimmung von HER2/neu in der Nadelbiopsie beim Mammakarzinom verlässlich ist. Bei immunhistochemisch stark positivem HER2/neu Status in der Nadelbiopsie sollte dies durch FISH überprüft werden, um die Zahl der falsch positiven Ergebnisse zu minimieren.

Summary

Introduction

The assessment of HER2/neu overexpression in tissue provides information about one of the most relevant prognostic and predictive markers in breast cancer: overexpression of HER2/neu is associated with worse prognosis in primary breast cancer. Since core needle biopsy is increasingly used for the diagnosis of breast cancer, the purpose of this study was to assess the reliability of HER2/neu evaluation using this technique in patients with primary breast cancer.

Patients and methods

We investigated the accuracy of immunohistochemical assessment of HER2/neu in core needle biopsies compared with surgically obtained specimens in 325 patients with primary breast cancer. In patients strongly positive for HER2/neu, additional fluorescence in situ hybridization (FISH) analysis of needle biopsies was performed.

Results

Using immunohistochemistry alone, accuracy of HER2/neu assessment in core biopsies in relation to surgically removed specimens was 92% and increased to 96% with additional FISH analysis (weighted Kappa coefficient: 0.86).

Discussion

As proven with this large series of patients, the assessment of HER2/neu status by core needle biopsy in breast cancer is accurate. Notwithstanding, in order to minimize the number of false-positive results, strongly positive core needle biopsies identified using immunohistochemistry should be confirmed by FISH analysis.

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Correspondence to Susanne Taucher MD.

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Taucher, S., Rudas, M., Mader, R.M. et al. Prognostic markers in breast cancer: the reliability of HER2/neu status in core needle biopsy of 325 patients with primary breast cancer. Wien Klin Wochenschr 116, 26–31 (2004). https://doi.org/10.1007/BF03040420

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  • DOI: https://doi.org/10.1007/BF03040420

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