Receptor discordance after nipple-sparing mastectomy

Rena Kojima¹, Makoto Ishitobi¹, Naomi Nagura², Ayaka Shimo^{3

4}, Hirohito Seki^{5

6}, Akiko Ogiya^{7

8}, Teruhisa Sakurai⁹, Yukiko Seto¹⁰, Shinsuke Sasada¹¹, Chiya Oshiro¹², Michiko Kato¹³, Takahiko Kawate¹⁴, Naoto Kondo¹⁵, Tadahiko Shien¹⁶

Affiliations

¹ Department of Breast Surgery, Mie University School of Medicine, Mie, Japan.
² Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan.
³ Department of Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kanagawa, Japan.
⁴ Department of Breast and Endocrine Surgery, Kawasaki Municipal Tama Hospital, Kanagawa, Japan.
⁵ Department of Breast Surgery, Saitama Medical Center, Saitama, Japan.
⁶ Depatment of Breast Surgery, Kyorin University School of Medicine, Tokyo, Japan.
⁷ Department of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
⁸ Depatment of Breast Surgery, Japanese red cross medical center, Tokyo, Japan.
⁹ Sakurai Breast Clinic, Wakayama, Japan.
¹⁰ Department of Breast and Endocrine Surgery, Osaka International Cancer Institute, Osaka, Japan.
¹¹ Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
¹² Department of Breast Surgery, Kaizuka City Hospital, Osaka, Japan.
¹³ Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan.
¹⁴ Department of Breast Surgery and Oncology, Tokyo Medical University Hospital, Tokyo, Japan.
¹⁵ Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
¹⁶ Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.

PMID: 39845638
PMCID: PMC11749963
DOI: 10.1016/j.sipas.2024.100239

Receptor discordance after nipple-sparing mastectomy

Rena Kojima et al. Surg Pract Sci. 2024.

. 2024 Mar 5:17:100239.

doi: 10.1016/j.sipas.2024.100239. eCollection 2024 Jun.

Authors

Affiliations

¹ Department of Breast Surgery, Mie University School of Medicine, Mie, Japan.
² Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan.
³ Department of Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kanagawa, Japan.
⁴ Department of Breast and Endocrine Surgery, Kawasaki Municipal Tama Hospital, Kanagawa, Japan.
⁵ Department of Breast Surgery, Saitama Medical Center, Saitama, Japan.
⁶ Depatment of Breast Surgery, Kyorin University School of Medicine, Tokyo, Japan.
⁷ Department of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
⁸ Depatment of Breast Surgery, Japanese red cross medical center, Tokyo, Japan.
⁹ Sakurai Breast Clinic, Wakayama, Japan.
¹⁰ Department of Breast and Endocrine Surgery, Osaka International Cancer Institute, Osaka, Japan.
¹¹ Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan.
¹² Department of Breast Surgery, Kaizuka City Hospital, Osaka, Japan.
¹³ Department of Breast Surgical Oncology, Showa University School of Medicine, Tokyo, Japan.
¹⁴ Department of Breast Surgery and Oncology, Tokyo Medical University Hospital, Tokyo, Japan.
¹⁵ Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
¹⁶ Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.

PMID: 39845638
PMCID: PMC11749963
DOI: 10.1016/j.sipas.2024.100239

Abstract

Background: Recent studies have shown that receptor status of breast cancer change between primary tumor and recurrence, which may influence treatment strategy and prognosis, but there are few reports on receptor discordance between primary tumors and local recurrence (LR) after nipple-sparing mastectomy (NSM).

Patients and methods: We collected 74 patients who had LR after NSM for newly diagnosed stages 0 to 3 breast cancer between 2008 and 2016 at 14 institutions. We classified into 4 subtypes based on hormone receptor (HR) and human epidermal growth factor receptor 2 (HER2). We evaluated clinicopathological factors that correlate with receptor discordance and assessed the impact of receptor discordance on survival.

Results: Discordance rates in estrogen receptor (ER), progesterone receptor (PgR) and HER2 were 9.5, 10.8 and 5.4 %, respectively. The most common change was from HR-/HER2+ to HR+/HER2+, and this pattern of receptor change occurred only in patients with nipple-areolar recurrence. Non-invasive tumors in LR, nipple-areolar recurrence (NAR), HR-/HER2+ primary tumor subtype, and the presence of chemotherapy for primary tumors were significantly associated with receptor discordance. With a median follow-up of 44.5 months (4-153 months), patients in the receptor-discordant group had no disease-free survival (DFS) event after LR resection (5-year DFS; 100 % in the receptor-discordant group vs 85.1 % in the receptor-concordant group; p = 0.2).

Conclusion: Our study demonstrates that the presence of chemotherapy for primary tumors, nipple-areolar recurrence, and its related factors (non-invasive tumor in LR, HR-/HER2+ primary tumor subtype) were associated with receptor discordance. However, further studies with longer follow-up periods and larger sample sizes are needed.

Keywords: Breast cancer; Local recurrence; Nipple-sparing mastectomy; Nipple–areolar recurrence; Subtype.

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Conflict of interest statement

Tadahiko Shien has received honoraria from Daiichi Sankyo, Chugai, and Lilly. The other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig 1 — **Fig. 1**
Disease-free survival curve according to receptor change.

See this image and copyright information in PMC

References

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Receptor discordance after nipple-sparing mastectomy

Affiliations

Receptor discordance after nipple-sparing mastectomy

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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Full Text Sources

Research Materials

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