Limitations in assessment of ER, PR, and HER2 status of breast cancer patients: Yangon experience.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11078-e11078
Author(s):  
Yin Yin Mon
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Advanced Technology ◽  
Molecular Profile ◽  
Molecular Testing ◽  
Breast Cancer Patients ◽  
Financial Problem ◽  
Lack Of Information ◽  
Number Of Patients ◽  
Her 2

e11078 Background: Management of breast cancer become individualized nowadays especially in developed countries. Molecular profile of breast cancer is essential to have this management. However, there are still limitations to examine such molecular profile in developing countries like Myanmar. Our aim in this study is to know the number of patients who underwent ER, PR and HER 2 status assessment among breast cancer patients in Myanmar and to analyze types of limitations for the molecular assessment in management of breast cancer. Methods: Total number of 823 breast cancer patients who registered from January 2009 to December 2011 at Medical Oncology Unit of Yangon General Hospital and two private oncology clinics were studied. Results: The age range from 19-80 years and mean age of 44.36 years. Among 823 breast cancer patients, ER, PR and HER 2 status were done in 134 patients (16.28% ) whereas 689 patients( 83.71% ) were not. 604 (87.66%) out of 689 patients who did not undergo profiling were due to financial problem. 60 patients (8.70 %) were found to have lack of information about molecular profiling although they were affordable . 25 patients (3.62 %) lost their tissue due to technological limitation Conclusions: Financial problem is the major limitation to get molecular profile for breast cancer patients in Myanmar. Patients need self expense to do advanced technology examinations in different health care system of our country. In this study we also found out that there was lack of information which leads not to undergo further investigations to some well to do patients. Overall, we believe that molecular technology support with reduced expense will help more patients in future to get better management in breast cancer in Myanmar. Besides, we need to provide update information about molecular testing in breast cancer to not only patients but also health professionals in our country.

Review of Estrogen Receptor, Progesterone Receptor, and HER-2/neu Immunohistochemistry Impacts on Treatment for a Small Subset of Breast Cancer Patients Transferring Care to Another Institution

2013 ◽  
Vol 137 (11) ◽  
pp. 1660-1663 ◽  
Author(s):  
Julie M. Jorns ◽  
Patrick Healy ◽  
Lili Zhao
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Progesterone Receptor ◽  
Cancer Patients ◽  
Treatment Recommendation ◽  
Small Subset ◽  
Breast Cancer Patients ◽  
Number Of Patients ◽  
Her 2 ◽  
Pathology Review

Context.—Estrogen receptor (ER), progesterone receptor (PR), and HER-2/neu studies are variably submitted for pathology review but are influential in treatment choices for breast cancer patients seeking second opinion or transferring care. Objective.—To determine the frequency of interinstitutional discordance for the interpretation of ER/PR and HER-2/neu immunohistochemical slides and assess the resulting clinical significance. Design.—One thousand one hundred thirty-nine ER, 1111 PR, and 663 HER-2/neu immunohistochemistry stains from 1139 cases were reviewed at contributing and referral centers and compared for concordance and clinical impact of discordance. Results.—Interinstitutional concordance for individual stains was excellent (ER: κ = 0.93; PR: κ = 0.90; HER-2/neu: κ = 0.93). One hundred four (9.1%) had interinstitutional discordance in 1 or more stains; however, the majority of the discordance was clinically insignificant. Seven patients (0.6%) had a clinically significant change in treatment recommendation based on review and 2 (0.2%) had interpretation changes that would likely have resulted in treatment change had they not already completed therapy. Two patients (0.2%) had change in treatment despite concordant interpretations. Conclusions.—Overall, there was excellent interinstitutional concordance for pathology review of ER, PR, and HER-2/neu immunohistochemistry stains. However, a small but significant number of patients (0.8%) received potential benefit from review, justifying inclusion of these slides along with other pathology slides to be reviewed for all breast cancer patients being seen at another institution who have not yet completed hormonal and/or chemotherapy.

Circulating Tumor Cells in HER-2 Positive Metastatic Breast Cancer Patients Treated with Trastuzumab and Chemotherapy

2009 ◽  
Vol 24 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Raquel A. Nunes ◽  
Xiaochun Li ◽  
Soonmo Peter Kang ◽  
Harold Burstein ◽  
Lisa Roberts ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Treatment Response ◽  
Cancer Patients ◽  
Tumor Cells ◽  
Circulating Tumor Cells ◽  
Peripheral Blood ◽  
Metastatic Breast ◽  
Breast Cancer Patients ◽  
Her 2

The detection of circulating tumor cells (CTCs) in peripheral blood may have important prognostic and predictive implications in breast cancer treatment. A limitation in this field has been the lack of a validated method of accurately measuring CTCs. While sensitivity has improved using RT-PCR, specificity remains a major challenge. The goal of this paper is to present a sensitive and specific methodology of detecting CTCs in women with HER-2-positive metastatic breast cancer, and to examine its role as a marker that tracks disease response during treatment with trastuzumab-containing regimens. The study included patients with HER-2-positive metastatic breast cancer enrolled on two different clinical protocols using a trastuzumab-containing regimen. Serial CTCs were measured at planned time points and clinical correlations were made. Immunomagnetic selection of circulating epithelial cells was used to address the specificity of tumor cell detection using cytokeratin 19 (CK19). In addition, the extracellular domain of the HER-2 protein (HER-2/ECD) was measured to determine if CTCs detected by CK19 accurately reflect tumor burden. The presence of CTCs at first restaging was associated with disease progression. We observed an association between CK19 and HER-2/ECD. The association of HER-2/ECD with clinical response followed a similar pattern to that seen with CK19. Finally, the absence of HER-2/ECD at best overall response and a change of HER-2/ECD from positive at baseline to negative at best overall response was associated with favorable treatment response. Our study supports the prognostic and predictive role of the detection of CTCs in treatment of HER-2-positive metastatic breast cancer patients. The association between CK19 and markers of disease burden is in line with the concept that CTCs may be a reliable measure of tumor cells in the peripheral blood of patients with metastatic breast cancer. The association of CTCs at first restaging with treatment failure indicates that CTCs may have a role as surrogate markers to monitor treatment response.

Serum HER-2: sensitivity, specificity, and predictive values for detecting metastatic recurrence in breast cancer patients

2013 ◽  
Vol 139 (6) ◽  
pp. 1005-1013 ◽  
Author(s):  
Patricia Diana Sørensen ◽  
Erik Hugger Jakobsen ◽  
Jonna Skov Madsen ◽  
Eva Brix Petersen ◽  
Rikke Fredslund Andersen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Breast Cancer Patients ◽  
Predictive Values ◽  
Metastatic Recurrence ◽  
Her 2 ◽  
Sensitivity Specificity
Sign in / Sign up

Export Citation Format

Share Document