scholarly journals Evaluation of Ki-67 Index in Core Needle Biopsies and Matched Breast Cancer Surgical Specimens

2017 ◽  
Vol 142 (3) ◽  
pp. 364-368 ◽  
Author(s):  
Soomin Ahn ◽  
Junghye Lee ◽  
Min-Sun Cho ◽  
Sanghui Park ◽  
Sun Hee Sung

Context.— The Ki-67 index is strongly prognostic and is used as a surrogate marker to distinguish luminal A from luminal B breast cancer types. Objective.— To investigate differences in Ki-67 index between core needle biopsy samples and matched surgical samples in breast cancer. Design.— We included patients with invasive breast cancer who did not receive neoadjuvant therapy. A total of 89 pairs of core needle biopsies and surgical specimens were collected, and the Ki-67 index was assessed in hot spot areas using an image analyzer. We applied a 14% Ki-67 index to define low versus high groups. Results.— The Ki-67 index was significantly higher in core needle biopsies than in surgical specimens (P < .001), with a median absolute difference of 3.5%. When we applied 14% as a cutoff, 16 of 89 cases (18%) showed discrepancy. Thirteen cases showed a high Ki-67 index in core needle biopsies but a low Ki-67 index in surgical samples. There were 10 cases (11.2%) that showed discordant luminal A/B types between core needle biopsy and the matched surgical specimen. The reasons for the discordance were poor staining of MIB1 accompanied by fixation issues and intratumoral heterogeneity of the Ki-67 index. Conclusions.— A significant difference in the Ki-67 index between core biopsy and surgical specimens was observed. Our findings indicate that it may be better to perform the Ki-67 assay on the core needle biopsy and the surgical specimen than on only one sample.

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22141-e22141
Author(s):  
V. Wolf ◽  
R. Groβe ◽  
J. Erggelet ◽  
H. J. Holzhausen ◽  
S. Hauptmann ◽  
...  

e22141 Background: A milestone of breast-cancer therapy was the discovery of HER-2 entailing special targeted therapy with improved prognosis. The HER-2-status is routinely assessed through immunohistochemistry (IHC; HercepTest) showing protein over-expression and is double-checked with in-situ-hybridisation (ISH) demonstrating gene amplification in equivocal cases. It is questioned whether these methods achieve identical results in core-needle-biopsies and in excisional tumor specimens. Methods: We performed a retrospective comparative study in order to address these questions. From 01/03–06/08 we collected the HercepTest results from both core-needle-biopsy and surgical specimen of 109 breast cancer patients in our institute and compared these to newly evaluated chromogenic ISH (CISH) results for both specimen types in order to assess the reliability of HER-2- diagnosis of both methodological approaches and of specimen type. Results: We found no significant difference in the HER- 2-status determined from either needle-biopsies or surgical specimens irrespective of the test used. For the overall comparison (218 specimens) of HercepTest and CISH we found only slight, non-significant deviations. Four cases were CISH-negative in spite of HercepTest scoring of 3+. Vice versa, five out of the total of 38 (17.4%) CISH-positives did not correspond to the HercepTest results of 0 or 1+. Conclusions: Though not significant, there is some inconsistency in the HER-2-determination depending on the test-method, leaving these cases equivocal. In accordance with the literature, we therefore recommend to at least double-check samples with 2+ in the HercepTest as it is the current standard. Our data support the use of core-needle-biopsy as a reliable tissue sample for HER-2-diagnosis. [Table: see text]


Author(s):  
Peng Qi ◽  
Yu Yang ◽  
Qian-ming Bai ◽  
Tian Xue ◽  
Min Ren ◽  
...  

Abstract Background Adjuvant therapy decisions may be partly based on the results of a multigene quantitative reverse transcription-polymerase chain reaction (RT-PCR)-based assay: the 21-gene recurrence score (RS) test of resection specimens. When necessary, core needle biopsy (CNB) may be considered as a surrogate. Here, we evaluated the concordance in gene expression according to results from RT-PCR-based RS testing between paired CNBs and resection specimens. Methods CNBs and resection specimens from 50 breast cancer (BC) patients were tested to calculate RSs. First, we examined the concordance of the ER, PR and HER-2 status of tissue samples indicated by immunohistochemical (IHC) and RT-PCR analyses. Then, we compared the IHC findings of ER, PR, HER-2 and Ki-67 staining across paired samples. Ultimately, the RS and single-gene results for ER, PR, HER-2 and Ki-67 were explored between paired samples. Results The concordance between IHC and RT-PCR was 100%, 80.0% and 100% for ER, PR and HER-2, respectively, in both resection specimens and CNBs. The concordance for IHC ER, PR, HER-2 and Ki-67 status was 100%, 94.0%, 52.0% and 82.0%, respectively, between paired samples. RS results from paired samples showed a strong correlation. The overall concordance in RS group classification between samples was 74%, 72% and 78% based on traditional cutoffs, TAILORx cutoffs and ASCO guidelines, respectively. ER, PR, HER-2 and Ki-67 were modestly- to- strongly correlated between paired samples according to the RT-PCR results. Conclusion A modest- to- strong correlation of ER, PR, HER-2 and Ki-67 gene expression and RS between CNBs and resection specimens was observed in the present study. The 21-gene RS test could be reliably performed on CNBs. ER, PR and HER-2 status showed remarkable concordance between the IHC and RT-PCR analyses. The concordance between paired samples was high for the IHC ER, PR and Ki-67 results and low for HER-2.


Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2067
Author(s):  
Ruth M. Parks ◽  
Mohammad Albanghali ◽  
Binafsha M. Syed ◽  
Andrew R. Green ◽  
Ian O. Ellis ◽  
...  

The majority of biological profiling studies use surgical excision (SE) samples, excluding patients receiving nonsurgical and neoadjuvant therapy. We propose using core needle biopsy (CNB) for biological profiling in older women. Over 37 years (1973–2010), 1 758 older (≥70 years) women with operable primary breast cancer attended a dedicated clinic. Of these, 693 had sufficient quality CNB to construct tissue microarray (TMA). The pattern of biomarkers was analysed in oestrogen receptor (ER)-positive cases, using immunohistochemistry and partitional clustering analysis. The biomarkers measured were: progesterone receptor (PgR), Ki67, Epidermal Growth Factor Receptor (EGFR), Human Epidermal Growth Factor Receptor (HER)-2, HER3, HER4, p53, cytokeratins CK5/6 and CK7/8, Mucin (MUC)1, liver kinase B1 (LKB1), Breast Cancer Associated gene (BRCA) 1, B-Cell Lymphoma (BCL)-2, phosphate and tensin homolog (PTEN), vascular endothelial growth factor (VEGF), and Amplified in breast cancer 1 (AIB1). CNB TMA construction was possible in 536 ER-positive cases. Multivariate analysis showed progesterone receptor (PgR) (p = 0.015), Ki67 (p = 0.001), and mucin (MUC)1 (p = 0.033) as independent predictors for breast-cancer-specific survival (BCSS). Cluster analysis revealed three biological clusters, which were consistent with luminal A, luminal B, and low-ER luminal. The low-ER luminal cluster had lower BCSS compared to luminal A and B. The presence of the low-ER luminal cluster unique to older women, identified in a previous study in SE TMAs in the same cohort, is confirmed. This present study is novel in its use of core needle biopsy tissue microarrays to profile the biology of breast cancer in older women.


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