J Breast Cancer.  2016 Sep;19(3):268-274. 10.4048/jbc.2016.19.3.268.

Patients with Concordant Triple-Negative Phenotype between Primary Breast Cancers and Corresponding Metastases Have Poor Prognosis

Affiliations
  • 1Department of Surgery, Chung-Ang University Hospital, Seoul, Korea.
  • 2Department of Surgery, Seoul National University Hospital, Seoul, Korea. dynoh@snu.ac.kr
  • 3Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.
  • 4Department of Pathology, Seoul National University Hospital, Seoul, Korea.

Abstract

PURPOSE
We investigated the prognostic impact of discordance between the receptor status of primary breast cancers and corresponding metastases.
METHODS
A total 144 patients with breast cancer and distant metastasis were investigated. The estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2) status of primary tumor and corresponding metastases were assessed. Tumor phenotype according to receptor status was classified as triple-negative phenotype (TNP) or non-TNP. Concordance and discordance was determined by whether there was a change in receptor status or phenotype between primary and metastatic lesions.
RESULTS
The rates of discordance between primary breast cancer and metastatic lesions were 18.1%, 25.0%, and 10.3% for ER, PR, and HER2, respectively. The rates of concordant non-TNP, concordant TNP and discordant TNP were 65.9%, 20.9%, and 13.2%, respectively. Patients with concordant ER/PR-negative status had worse postrecurrence survival (PRS) than patients with concordant ER/PR-positive and discordant ER/PR status (p=0.001 and p=0.021, respectively). Patients who converted from HER2-positive to negative after distant metastasis had worst PRS (p=0.040). Multivariate analysis showed that concordant TNP was statistically significant factor for worse PRS (p<0.001).
CONCLUSION
Discordance in receptor status and tumor phenotype between primary breast cancer and corresponding metastatic lesions was observed. Patients with concordant TNP had worse long-term outcomes than patients with concordant non-TNP and discordant TNP between primary and metastatic breast cancer. Identifying the receptor status of metastatic lesions may lead to improvements in patient management and survival.

Keyword

Breast neoplasms; erbB-2; Estrogen receptor; Progesterone receptor; Survival

MeSH Terms

Breast Neoplasms
Breast*
Estrogens
Humans
Multivariate Analysis
Neoplasm Metastasis*
Phenotype*
Prognosis*
Receptor, Epidermal Growth Factor
Receptors, Progesterone
Estrogens
Receptor, Epidermal Growth Factor
Receptors, Progesterone
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