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

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.

• Publication year

  2016

• Venue

  Journal of Breast Cancer

• Publication date

  2016-09-01

• Fields of study

  Medicine

• Identifiers
  DOI 10.4048/jbc.2016.19.3.268PMID 27721876PMCID 5053311
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Hormone Receptor Status and HER2 Expression in Primary Breast Cancer Compared With Synchronous Axillary Metastases or Recurrent Metastatic Disease.

  2015cited by this paper
• Prognostic implications of receptor discordance between primary and recurrent breast cancer

  2015cited by this paper
• [Prevalence of hormonal receptors and human epidermal growth factor receptor 2 in Mexican female patients with breast cancer].

  2014cited by this paper
• Impact of the 7th Edition AJCC staging classification on the NCCN clinical practice guidelines in oncology for gastric and esophageal cancers.

  2013cited by this paper
• Loss of HER2 positivity and prognosis after neoadjuvant therapy in HER2-positive breast cancer patients.

  2013cited by this paper
• Recommendations for human epidermal growth factor receptor 2 testing in breast cancer: American Society of Clinical Oncology/College of American Pathologists clinical practice guideline update.

  2013cited by this paper
• Discordance in receptor status between primary and recurrent breast cancer has a prognostic impact: a single-institution analysis.

  2013cited by this paper
• Hormonal Receptor, Human Epidermal Growth Factor Receptor-2, and Ki67 Discordance between Primary Breast Cancer and Paired Metastases: Clinical Impact

  2012cited by this paper
• Prognostic Value of a Positive-to-negative Change in Hormone Receptor Status after Neoadjuvant Chemotherapy in Patients with Hormone Receptor–positive Breast Cancer

  2012cited by this paper
• Loss of human epidermal growth factor receptor 2 (HER2) expression in metastatic sites of HER2-overexpressing primary breast tumors.

  2012cited by this paper
• Clinically used breast cancer markers such as estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 are unstable throughout tumor progression.

  2012cited by this paper
• Hormone receptor and c-ERBB2 status in distant metastatic and locally recurrent breast cancer. Pathologic correlations and clinical significance.

  2010cited by this paper
• Loss of HER2 Amplification Following Trastuzumab-Based Neoadjuvant Systemic Therapy and Survival Outcomes

  2009cited by this paper
• Prognostic impact of discordance between triple-receptor measurements in primary and recurrent breast cancer.

  2009influential reference
• Changes in estrogen receptor, progesterone receptor and Her-2/neu status with time: discordance rates between primary and metastatic breast cancer.

  2009cited by this paper
• Mutational evolution in a lobular breast tumour profiled at single nucleotide resolution

  2009cited by this paper
• HER-2/neu expression in primary and metastatic breast cancer

  2008cited by this paper
• Heterogeneity of Breast Cancer Metastases: Comparison of Therapeutic Target Expression and Promoter Methylation Between Primary Tumors and Their Multifocal Metastases

  2008cited by this paper
• Comparison of HER-2 and hormone receptor expression in primary breast cancers and asynchronous paired metastases: impact on patient management.

  2008cited by this paper
• Optimal fixation conditions for immunocytochemical analysis of estrogen receptor in cytologic specimens of breast carcinoma

  2003cited by this paper
• Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications

  2001cited by this paper
• Molecular portraits of human breast tumours

  2000cited by this paper
• The measurement of observer agreement for categorical data.

  1977cited by this paper
• Diseases of the Breast

  1888cited by this paper
• Recommendations for Human Epidermal Growth Factor Receptor 2 Testing in Breast Cancer

  year unknowncited by this paper

• Prognostic value of HER2 discordance between primary and metastatic or recurrent breast cancer: a systematic review and meta-analysis.

  2025cites this paper
• Hormone receptor conversion in metastatic breast cancer

  2024cites this paper
• The heterogeneous subclones might be induced by cycling hypoxia which was aggravated along with the luminal A tumor growth.

  2022cites this paper
• Prognostic significance of receptor expression discordance between primary and recurrent breast cancers: a meta-analysis

  2021cites this paper
• Comparative study of Hormonal Receptor Status Discrepancy - Brain Breast Cancer Metastasectomy vs Other Localities.

  2021cites this paper
• Hormone receptor, human epidermal growth factor receptor-2, and Ki-67 status in primary breast cancer and corresponding recurrences or synchronous axillary lymph node metastases

  2019cites this paper
• Quadruple Negative Breast Cancers (QNBC) Demonstrate Subtype Consistency among Primary and Recurrent or Metastatic Breast Cancer

  2018cites this paper
• Comment to “Patients with Concordant Triple-Negative Phenotype between Primary Breast Cancers and Corresponding Metastases Have Poor Prognosis”

  2016cites this paper