The c-erbB-2 Protein in Primary and Metastatic Breast Carcinomas

Abstract Context.—Breast carcinoma often metastasizes to the gastrointestinal tract, especially the stomach, where it is frequently difficult to distinguish from a primary gastric carcinoma. Objective.—To evaluate the utility of immunohistochemical stains in differentiating primary gastric carcinomas from metastatic breast carcinomas. Design.—Mucosal biopsy specimens from 47 adenocarcinomas involving the gastrointestinal tract (28 primary gastric carcinomas and 19 metastatic breast carcinomas) and 16 control cases of primary breast carcinomas without metastasis were immunohistochemically stained for estrogen receptor protein (ER), progesterone receptor protein (PR), gross cystic disease fluid protein (GCDFP), human epidermal growth factor receptor 2 protein, cytokeratin (CK) 5/6, CK/7, CK/20, a panel of mucin glycoprotein antigens (MUC2, MUC3, MUC5AC, and MUC6), monoclonal antibody DAS-1, and caudal-type homeobox transcription factor CDX2 and compared between primary and metastatic adenocarcinomas. Results.—Highly significant proportions of metastatic breast carcinomas were positive for ER (72%), PR (33%), GCDFP (78%), and CK5/6 (61%) compared with primary gastric carcinomas (ER, 0%; PR, 0%; GCDFP, 0%; and CK5/6, 14%) (P < .001, P = .002, P < .001, and P = .004, respectively). Of these immunostains, ER, PR, and GCDFP were 100% specific. Primary breast tumors and their metastases showed a similar phenotypic profile. In contrast, primary gastric carcinomas showed significantly higher proportions of cases that stained with CK20 (50%), MUC2 (54%), MUC5AC (71%), MUC6 (39%), DAS-1 (43%), and CDX2 (67%) compared with metastatic breast carcinomas (CK20, 0%; MUC2, 24%; MUC5AC, 6%; MUC6, 0%; DAS-1, 0%; and CDX2, 0%) (P = .001, P = .01, P < .001, P = .02, P = .009, and P < .001, respectively). No significant differences were observed with regard to any of the other immunostains (human epidermal growth factor receptor 2 protein, CK7, and MUC3) between the patient groups. Conclusions.—Estrogen receptor protein, PR, GCDFP, CK5/6, CK20, MUC5AC, MUC6, DAS-1, and CDX2 are helpful in distinguishing primary gastric carcinomas from metastatic breast carcinomas. Of these, ER, PR, and GCDFP are highly specific for metastatic breast carcinomas, whereas CK20, DAS-1, MUC2, MUC5AC, MUC6, and CDX2 are highly specific for primary gastric carcinomas.

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HER-2/neu expression in ovarian clear cell carcinomas

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200301000-00005 ◽

2003 ◽

Vol 13 (1) ◽

pp. 28-31 ◽

Cited By ~ 1

Author(s):

H. Iwamoto ◽

H. Fukasawa ◽

T. Honda ◽

S. Hirata ◽

K. Hoshi

Keyword(s):

Breast Carcinoma ◽

Cell Carcinoma ◽

San Francisco ◽

Clear Cell ◽

Clear Cell Carcinoma ◽

Metastatic Breast ◽

Breast Carcinomas ◽

Ovarian Clear Cell Carcinoma ◽

Clinical Prognosis ◽

Her 2

HER-2 /neu is a 185-kDa glycoprotein and a transmembrane receptor with tyrosine kinase activity. Its overexpression is observed in 25–30% of primary breast carcinomas and is associated with a poor clinical prognosis. Recently, the U.S. Food and Drug Administration and the Japanese Ministry of Health, Welfare, and Labor approved the use of trastuzumab (Herceptin, Genentech, South San Francisco, CA) for the treatment of patients with metastatic breast carcinomas overexpressing HER-2 /neu. Results of clinical trials with Herceptin suggest that it may prolong the survival of patients with advanced metastatic breast carcinoma. Relatively little is known concerning the relationship between HER-2 /neu status and ovarian clear cell carcinoma. If HER-2 /neu overexpression status were demonstrable in ovarian clear cell carcinoma and a clinical correlation between overexpression and prognosis could be established, a rationale for clinical use of Herceptin for this tumor could be established. Our aim was to evaluate HER-2 /neu status in ovarian clear cell carcinomas. Fifteen ovarian clear cell carcinoma cases were immunostained for HER-2 /neu using HercepTest (DAKO, Glostrup, Denmark). Overexpression of HER-2 /neu was detected in only one case. Unlike in breast carcinoma, HER-2 /neu overexpression appeared to be uncommon in ovarian clear cell carcinomas. Herceptin may thus target only a small proportion of ovarian clear cell carcinomas and be of limited clinical value for treatment of this carcinoma.

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Value of gross cystic disease fluid protein-15 in distinguishing metastatic breast carcinomas among poorly differentiated neoplasms involving the ovary

Human Pathology ◽

10.1016/0046-8177(91)90084-3 ◽

1991 ◽

Vol 22 (4) ◽

pp. 368-372 ◽

Cited By ~ 76

Author(s):

Carlos Monteagudo ◽

Maria J. Merino ◽

Noemi LaPorte ◽

Ronald D. Neumann

Keyword(s):

Metastatic Breast ◽

Cystic Disease ◽

Breast Carcinomas ◽

Poorly Differentiated ◽

Cystic Disease Fluid Protein

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PP-8-2 First line tamoxifen for invasive hormonal sensitive non metastatic breast carcinomas in young postmenopausal patients

European Journal of Cancer ◽

10.1016/0959-8049(96)84238-9 ◽

1996 ◽

Vol 32 ◽

pp. 49 ◽

Cited By ~ 1

Author(s):

L Mauriac ◽

M. Durand ◽

F. Bonichon ◽

A. Roquet

Keyword(s):

Metastatic Breast ◽

Breast Carcinomas ◽

First Line

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Hepatocyte nuclear factor 4A expression discriminates gastric involvement by metastatic breast carcinomas from primary gastric adenocarcinomas

Human Pathology ◽

10.1016/j.humpath.2011.04.002 ◽

2011 ◽

Vol 42 (11) ◽

pp. 1777-1784 ◽

Cited By ~ 14

Author(s):

Taiga Koyama ◽

Shigeki Sekine ◽

Hirokazu Taniguchi ◽

Hitoshi Tsuda ◽

Masahiro Ikegami ◽

...

Keyword(s):

Metastatic Breast ◽

Nuclear Factor ◽

Hepatocyte Nuclear Factor ◽

Breast Carcinomas ◽

Gastric Adenocarcinomas

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Correlation of Expression of Breast Biomarkers in Primary and Metastatic Breast Carcinomas: A Single-Institution Experience

Acta Cytologica ◽

10.1159/000449400 ◽

2016 ◽

Vol 60 (5) ◽

pp. 481-489 ◽

Cited By ~ 4

Author(s):

Yanjun Hou ◽

Rulong Shen ◽

Shweta Chaudhary ◽

Faye Gao ◽

Zaibo Li

Keyword(s):

Small Sample Size ◽

Growth Factor Receptor ◽

Metastatic Breast ◽

Small Sample ◽

Her2 Status ◽

Study Cohort ◽

Breast Carcinomas ◽

Status Change ◽

Primary Tumors ◽

The Status

Objective: Changes in the status of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) in metastatic breast carcinomas are frequently reported. We examined the change in the status of biomarkers in metastatic breast carcinomas. Study Design: This study cohort was composed of 137 metastatic breast carcinomas (58 surgical and 79 cytological specimens) with existing primary tumors during a study period from 2013 to 2015. Results: The overall change rates in metastases were 9, 21 and 6% for ER, PR and HER2, respectively. All changes were from positive in the primary tumor to negative in the metastases. The ER change rate was significantly higher in the cytological than in the surgical metastases. Six of 14 cytological metastases with positive HER2 in primary tumors showed a change in HER2 status, including 5 fluid specimens and 1 fine-needle aspiration (FNA); the other 8 had no change in HER2 status, and included 7 FNAs and 1 fluid specimen. Conclusion: The significant percentage of cases with a change in biomarker status supports the recommendation by the College of American Pathologists to test breast biomarkers in metastases. HER2 status change was mostly identified in fluid specimens; however, the small sample size in our cohort and the fact that HER2 fluorescence in situ hybridization was not performed may warrant further studies.

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