KMID : 1134120170200030297
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Journal of Breast Cancer 2017 Volume.20 No. 3 p.297 ~ p.303
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Comparison of Core Needle Biopsy and Surgical Specimens in Determining Intrinsic Biological Subtypes of Breast Cancer with Immunohistochemistry
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You Ki-Ho
Park Sung-Min Ryu Jai-Min Kim Isaac Lee Se-Kyung Yu Jong-Han Kim Seok-Won Nam Seok-Jin Lee Jeong-Eon
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Abstract
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Purpose: We evaluated the concordance between core needle biopsy (CNB) and surgical specimens on examining intrinsic biological subtypes and receptor status, and determined the accuracy of CNB as a basic diagnostic method.
Methods: We analyzed breast cancer patients with paired CNB and surgical specimen samples during 2014. We used monoclonal antibodies for nuclear staining, and estrogen receptor (ER) and progesterone receptor (PR) status evaluation. A positive test was defined as staining greater than or equal to 1% of tumor cells. Human epidermal growth factor receptor 2 (HER2) was graded by immunohistochemistry and scored as 0 to 3+ according to the recommendations of the American Society of Clinical Oncology/College of American Pathologists. Ki-67 immunostaining was performed using the monoclonal antibody Ki-67, and the results were divided at 10% intervals. The cutoff value for high Ki-67 was defined as 20%. Concordance analysis of ER, PR, HER2, Ki-67, and five intrinsic biological subtypes was performed on CNB and surgical specimens. Statistical analysis for concordance was calculated using ¥ê-tests.
Results: We found very good agreement for ER and PR with a concordance of 96.7% for ER (¥ê=0.903), and 94.3% for PR (¥ê=0.870). HER2 and Ki-67 showed concordance rates of 84.8% (¥ê=0.684) and 83.5% (¥ê=0.647), respectively, which were interpreted as good agreement. Five subgroups analysis showed 85.8% agreement and ¥ê-value of 0.786, also indicating good agreement.
Conclusion: CNB showed high diagnostic accuracy compared with surgical specimens, and good agreement for ER, PR, HER2, and Ki-67. Our findings reaffirmed the recommendation of CNB as an initial procedure for breast cancer diagnosis, and the assessment of receptor status and intrinsic biological subtypes to determine further treatment plans.
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KEYWORD
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Breast neoplasms, Core needle biopsy, Estrogen receptors, Human epidermal growth factor receptor 2, Immunohistochemistry
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