Evaluation of Receptor Conversion and Her2 Discordance Between Primary and Metastatic Breast Cancer and Predictive Factors Publisher



Saeedian A^{1, 2} ; Lahkari M^{1, 2} ; Naderinasab S^{1, 2} ; Ghalehtaki R^{1, 2} ; Kazemian A^{1, 2} ; Foroushan AR³ ; Hadavi V⁴ Show Affiliations
Source: Iranian Journal of Breast Diseases Published:2022

Abstract

Introduction: The majority of treatment decisions of breast cancer are currently determined primarily based on the state of the primary tumor receptors and the patient's functional status. However, changes in the status of hormone receptors at the site of metastasis have been observed with a high frequency in metastatic breast cancer; this study aimed to investigate the rate of receptor conversion and its impact on survival outcomes. Method: The records of patients diagnosed with metastatic breast cancer who had been treated between 2013 and 2018 at the Cancer Institute, Imam Khomeini Hospital, were retrieved. Demographic and clinical information of patients and the prevalence of receptors in primary and metastatic masses were collected and analyzed using appropriate statistical tests. Results: Of the 150 women with breast cancer, 31 (20.66%) had changes in E R, with 13 (41.93%) patients having a positive alteration and 18 (58.7%) having a negative change in metastatic compared with primary tumors. In 41 patients (27.33%) PR conversion had occurred, with gain of expression in 19 patients (46.34%) and loss of expression in 22 patients (53.66%). Finally, discordance in H E R 2 expression was observed in 23 cases (15.33%), of whom 12 (52.17%) showed positive conversion, while 11 patients (47.83%) had a negative conversion. The conversion of hormone receptors was mostly negative, whereas the change in H E R 2 was mostly positive. Receptor discordance was significantly higher in patients who had lymphovascular invasion compared with those who did not have lymphovascular invasion (P = 0.023). No significant relationship was observed between receptor conversion and the stage of the disease or the age of the patients. Conclusion: It seems that patients with lymphovascular invasion are good candidates for re-evaluation of hormone receptor status in metastatic lesions. To determine which patients would benefit most from a biopsy of the metastatic tumor, more studies are required. © 2022 Elsevier Masson SAS. All rights reserved.