Abstract
Background
Core needle biopsy (CNB) plays a crucial role as diagnostic tool for breast cancer
(BC). The characterization of biomarkers status before surgical treatment is crucial
when primary systemic therapy is a therapeutic option. The aim of this analysis was
to report concordance between preoperative CNB and surgical specimen (SS) in evaluating
biomarkers and molecular subtypes.
Methods
Data have been collected from a cohort of 101 patients affected by early BC treated
at Careggi Florence University Hospital, between January 2014 and March 2015. The
conformity between molecular subtype classification was tested using kappa (κ) test.
Results
Mean age was 57.5 years (range 29–86). There was concordance between the estrogen
receptor (ER) assessment on CNB and SS in 95 cases (94.1%). Concordance of the progesterone
receptor (PgR) assessment was observed in 89 cases (88.1%). Concordance for detecting immunohistochemistry-assessed
BC molecular subtypes was 87.1% (κ = 0.78). Concerning Ki-67 evaluation, we report
a concordance rate of 88.1% (κ = 0.68). The evaluation of luminal A plus luminal B/HER
negative subgroup showed a κ-value of 0.65.
Conclusions
CNB showed good accuracy in evaluating hormonal receptors status, HER2, and BC molecular
subtypes. Evaluation of Ki67 status was less accurate than other biomarkers; therefore,
we recommend that it should be detected both on CNB and SS samples, especially in
hormonal positive HER2 negative tumors, in order to avoid a misclassification of tumor
subtypes that could lead to an omission of potential effective systemic therapy.
Keywords
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Article info
Publication history
Published online: November 17, 2016
Accepted:
October 31,
2016
Identification
Copyright
© 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
