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Review
. 2023 Apr;198(3):573-582.
doi: 10.1007/s10549-023-06872-9. Epub 2023 Feb 21.

Concordance of immunohistochemistry for predictive and prognostic factors in breast cancer between biopsy and surgical excision: a single-centre experience and review of the literature

Chiara Rossi  1 , Sara Fraticelli  2 , Marianna Fanizza  3 , Alberta Ferrari  4 , Elisa Ferraris  5 , Alessia Messina  2 , Angelica Della Valle  4 , Chiara Annunziata Pasqualina Anghelone  4 , Angioletta Lasagna  5 , Gianpiero Rizzo  5 , Lorenzo Perrone  5 , Maria Grazia Sommaruga  3 , Giulia Meloni  3 , Silvia Dallavalle  3 , Elisabetta Bonzano  6 , Marco Paulli  2 , Giuseppe Di Giulio  3 , Adele Sgarella  4 , Marco Lucioni  2
Affiliations
Review

Concordance of immunohistochemistry for predictive and prognostic factors in breast cancer between biopsy and surgical excision: a single-centre experience and review of the literature

Chiara Rossi et al. Breast Cancer Res Treat. 2023 Apr.

Abstract

Purpose: Accurate evaluation of breast cancer on bioptic samples is of fundamental importance to guide therapeutic decisions, especially in the neoadjuvant or metastatic setting. We aimed to assess concordance for oestrogen receptor (ER), progesterone receptor (PR), c-erbB2/HER2 and Ki-67. We also reviewed the current literature to evaluate our results in the context of the data available at present.

Methods: We included patients who underwent both biopsy and surgical resection for breast cancer at San Matteo Hospital, Pavia, Italy, between January 2014 and December 2020. ER, PR, c-erbB2, and Ki-67 immunohistochemistry concordance between biopsy and surgical specimen was evaluated. ER was further analysed to include the recently defined ER-low-positive in our analysis.

Results: We evaluated 923 patients. Concordance between biopsy and surgical specimen for ER, ER-low-positive, PR, c-erbB2 and Ki-67 was, respectively, 97.83, 47.8, 94.26, 68 and 86.13%. Cohen's κ for interobserver agreement was very good for ER and good for PR, c-erbB2 and Ki-67. Concordance was especially low (37%) in the c-erbB2 1 + category.

Conclusion: Oestrogen and progesterone receptor status can be safely assessed on preoperative samples. The results of this study advise caution in interpreting biopsy results regarding ER-low-positive, c-erbB2/HER and Ki-67 results due to a still suboptimal concordance. The low concordance for c-erbB2 1 + cases underlines the importance of further training in this area, in the light of the future therapeutic perspectives.

Keywords: Biomarkers; Breast cancer; Er-low-positive; Immunohistochemistry; Preoperative diagnosis; her2-low.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Example of ER-LP discordance between biopsy and surgical specimen. On biopsy, (A, HE, 10x, B, ER immunohistochemistry, 10x) the tumour showed only faint, very focal (arrowhead) positivity for ER, that was quantified at 1%. The surgical specimen (C, HE, 5x, D–F, ER immunohistochemistry, 5x) revealed a dishomogeneous and faint ER positivity. Note the positive internal control (arrowhead) in the top-left corner of panel (E)
See this image and copyright information in PMC

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