Clinicopathologic factors affecting discrepancies in HER2 overexpression between core needle biopsy and surgical biopsy in breast cancer patients according to neoadjuvant treatment or not

24 Background: Lymphatic and/or vascular invasion (LVI) is not uniformly reported in breast cancer tumors, and may be absent even in LN+ patients. The purpose of this study was to define factors associated with (a) the non-reporting of LVI, and (b) the finding of no LVI in LN+ patients. Methods: Data from 400 LN+ patients from a cohort of patients in a prospective multicenter study were reviewed. Institutional and clinicopathologic factors correlating with the reporting and finding of LVI were assessed using non-parametric statistical analysis. Results: Of the 400 LN+ patients in this cohort, LVI was not reported in 98 (24.5%) patients. Of the remaining 302 patients, LVI was reported as negative in 147 (48.7%). LVI was more often reported in later years (84.9% in 2001-2004 vs. 67.9% in 1997-2000, p<0.001). The reporting of LVI did not vary significantly by region, teaching affiliation, community size, or the surgeon’s proportion of breast practice or number of cases. Further, reporting of LVI was not associated with surgery type, patient age, number of positive nodes, size of largest metastasis, nor extracapsular extension. LVI was, however, more frequently reported in larger tumors (median tumor size 2.0 cm vs. 1.8 cm, p=0.030). Despite the finding that LVI was more frequently reported in later years, the proportion of patients found to have LVI did not vary by year (53.3% in 2001-2004 vs. 49.3% in 1997-2000, p=0.565), region, teaching affiliation, community size, or surgeon practice. LVI positivity was associated with younger age (median age 53 vs. 60, p=0.001), larger tumors (median size 2.5 vs. 1.8 cm, p<0.001), more positive lymph nodes (median 2.5 vs. 1, p<0.001), more macrometastases (58.7% vs. 36.5%, p=0.002), and more extracapsular extension (70.3% vs. 46.0%, p=0.001). Conclusions: Reporting of LVI has improved in recent years, and while the rate of LVI positivity has not changed in LN+ patients, it remains associated with poor prognostic factors in this cohort. Therefore, reporting of LVI should be encouraged as a standard part of synoptic pathology reports for breast cancer patients, regardless of lymph node status.

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Strategy for Diagnosing Breast Cancer in Indonesia during the COVID-19 Pandemic: Switching to Ultrasound-Guided Percutaneous Core Needle Biopsy

Kesmas National Public Health Journal ◽

10.21109/kesmas.v16i3.4359 ◽

2021 ◽

Vol 16 (3) ◽

Author(s):

Farida Briani Sobri ◽

Adang Bachtiar ◽

Sonar Soni Panigoro ◽

Juwita Cresti Rahmaania ◽

Patria Wardana Yuswar ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Hospital Environment ◽

Breast Cancer Patients ◽

Ultrasound Guided ◽

Core Needle ◽

The Us ◽

Percutaneous Core Needle Biopsy

In this era of COVID-19, suspected breast cancer patients experience delay in diagnosis due to the fear of contracting the virus and reduction of non-COVID-19 health services. Furthermore, it may lead to potential increase in the incidence of advanced cancers in the future. Ultrasound-guided (US-guided) percutaneous core needle biopsy (CNB) is a great option for the diagnosis of cancer but it is poorly utilized. This study aimed to prove that the US-guided CNBis accurate when performed in a local setting and a potential solution for diagnosing breast cancer patients in this pandemic. In addition, it was a single health center cross-sectional study, and the participants were all breast cancer patients that had US-guided CNB from 2013-2019. The pathology results from US-guided CNB were compared to specimens from post-CNB surgeries. The data were collected from medical records and the immunohistochemistry (IHC) examinations were carried out for malignancy. There were 163 patients who were included in this study, 86 had malignancies and 77 had benign tumor reported in their CNB results. The US-guided CNB had 100% sensitivity and specificity compared to surgery. With its lower cost, time usage, and patient exposure to the hospital environment, US-guided CNB should replace open surgery biopsy for diagnosing suspicious breast cancers during the pandemic in Indonesia.

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