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. 2011 Jul;459(1):1-10.
doi: 10.1007/s00428-011-1097-7. Epub 2011 Jun 4.

Comparison of hormonal receptor and HER-2 status between breast primary tumours and relapsing tumours: clinical implications of progesterone receptor loss

Giuseppe Bogina  1 , Laura Bortesi, Marcella Marconi, Marco Venturini, Gianluigi Lunardi, Francesca Coati, Alberto Massocco, Erminia Manfrin, Cristina Pegoraro, Giuseppe Zamboni
Affiliations

Comparison of hormonal receptor and HER-2 status between breast primary tumours and relapsing tumours: clinical implications of progesterone receptor loss

Giuseppe Bogina et al. Virchows Arch. 2011 Jul.

Abstract

Differences in hormone receptor and HER-2 status between primary tumour and corresponding relapse could have a substantial impact on clinical management of patients. The aim of this study was to evaluate change in expression of hormone receptors and HER-2 status between primary tumour and corresponding local recurrence or distant metastasis. We analysed 140 primary tumours and related recurrent or metastatic samples. Hormone receptors status was evaluated by immunohistochemistry, while HER-2 status by immunohistochemistry and silver in situ hybridisation. A change in HER-2 was rare; 3.7% of cases by immunohistochemistry and only 0.7% by silver in situ hybridisation analysis. A change in estrogen and progesterone receptors was seen in 6.4% and 21.4% of cases, respectively. Estrogen receptor change was not affected by adjuvant therapy, whereas progesterone receptor was influenced by adjuvant chemotherapy associated to hormone therapy (P = 0.0005). A change in progesterone receptor was more frequent in distant metastases than in local recurrences (P = 0.03). In the setting of estrogen receptor positive tumours, patients with progesterone receptor loss in local recurrence had a statistically significant lower median metastasis free survival compared to others patients; progesterone receptor positive, 112 months; progesterone receptor negative, 24 months (P = 0.005). A change between primary tumour and corresponding relapse is frequent for progesterone receptor, infrequent for estrogen receptor and rare for HER-2. In cases with changes in HER-2, it is worthwhile reassessing HER-2 status with both immunohistochemistry and in situ hybridisation analysis. Progesterone receptor loss seems to be influenced by therapy and to correlate with a worse prognosis.

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Figures

Fig. 1
Fig. 1
Different morphology (H&E) between ductal like primary tumour (a) and lobular like local recurrence (b). Immunohistochemistry showed different staining for E-cadherin and HER-2 between the primary tumour (c, e) and the recurrence (d, f)
Fig. 2
Fig. 2
Kaplan–Meier estimate of metastasis free survival according to PT/LR receptor status. Groups (A, B, C) are defined in Clinical results
See this image and copyright information in PMC

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