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Factors influencing agreement of breast cancer luminal molecular subtype by Ki67 labeling index between core needle biopsy and surgical resection specimens.

  • Tendl-Schulz KA Department of Pathology and Comprehensive Cancer Center, Medical University of Vienna, 18-20 Waehringer Guertel, A-1090, Vienna, Austria.
  • Rössler F Department of Surgery and Transplantation, University Hospital and University of Zurich, Zurich, Switzerland.
  • Wimmer P Department of Pathology and Comprehensive Cancer Center, Medical University of Vienna, 18-20 Waehringer Guertel, A-1090, Vienna, Austria.
  • Heber UM Department of Pathology and Comprehensive Cancer Center, Medical University of Vienna, 18-20 Waehringer Guertel, A-1090, Vienna, Austria.
  • Mittlböck M Center for Medical Statistics, Informatics, and Intelligent Systems, Section for Clinical Biometrics, Medical University of Vienna, Vienna, Austria.
  • Kozakowski N Department of Pathology and Comprehensive Cancer Center, Medical University of Vienna, 18-20 Waehringer Guertel, A-1090, Vienna, Austria.
  • Pinker K Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria.
  • Bartsch R Department for Medicine I/Division of Oncology, Medical University of Vienna, Vienna, Austria.
  • Dubsky P Department of Surgery and Breast Health Center, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
  • Fitzal F Department of Surgery and Breast Health Center, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
  • Filipits M Institute of Cancer Research and Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria.
  • Eckel FC Department of Surgery and Breast Health Center, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
  • Langthaler EM Department of Pathology and Comprehensive Cancer Center, Medical University of Vienna, 18-20 Waehringer Guertel, A-1090, Vienna, Austria.
  • Steger G Department for Medicine I/Division of Oncology, Medical University of Vienna, Vienna, Austria.
  • Gnant M Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
  • Singer CF Department of Obstetrics and Gynaecology and Breast Health Center, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
  • Helbich TH Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria.
  • Bago-Horvath Z Department of Pathology and Comprehensive Cancer Center, Medical University of Vienna, 18-20 Waehringer Guertel, A-1090, Vienna, Austria. zsuzsanna.bago-horvath@meduniwien.ac.at.
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  • 2020-05-09
Published in:
  • Virchows Archiv : an international journal of pathology. - 2020
Agreement
Breast cancer
Core needle biopsy
Ki67
Luminal molecular subtype
Adult
Aged
Aged, 80 and over
Biopsy, Large-Core Needle
Breast Neoplasms
Disease Progression
Female
Humans
Immunohistochemistry
Ki-67 Antigen
Middle Aged
Neoplasm Grading
Neoplasm Recurrence, Local
Predictive Value of Tests
Progression-Free Survival
Receptor, ErbB-2
Receptors, Estrogen
Receptors, Progesterone
Reproducibility of Results
Retrospective Studies
Risk Factors
Time Factors
Tumor Suppressor Protein p53
English Reliable determination of Ki67 labeling index (Ki67-LI) on core needle biopsy (CNB) is essential for determining breast cancer molecular subtype for therapy planning. However, studies on agreement between molecular subtype and Ki67-LI between CNB and surgical resection (SR) specimens are conflicting. The present study analyzed the influence of clinicopathological and sampling-associated factors on agreement. Molecular subtype was determined visually by Ki67-LI in 484 pairs of CNB and SR specimens of invasive estrogen receptor (ER)-positive, human epidermal growth factor (HER2)-negative breast cancer. Luminal B disease was defined by Ki67-LI > 20% in SR. Correlation of molecular subtype agreement with age, menopausal status, CNB method, Breast Imaging Reporting and Data System imaging category, time between biopsies, type of surgery, and pathological tumor parameters was analyzed. Recurrence-free survival (RFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. CNB had a sensitivity of 77.95% and a specificity of 80.97% for identifying luminal B tumors in CNB, compared with the final molecular subtype determination after surgery. The correlation of Ki67-LI between CNB and SR was moderate (ROC-AUC 0.8333). Specificity and sensitivity for CNB to correctly define molecular subtype of tumors according to SR were significantly associated with tumor grade, immunohistochemical progesterone receptor (PR) and p53 expression (p < 0.05). Agreement of molecular subtype did not significantly impact RFS and OS (p = 0.22 for both). The identified factors likely mirror intratumoral heterogeneity that might compromise obtaining a representative CNB. Our results challenge the robustness of a single CNB-driven measurement of Ki67-LI to identify luminal B breast cancer of low (G1) or intermediate (G2) grade.
Language
  • English
Open access status
hybrid
Identifiers
Persistent URL
https://folia.unifr.ch/global/documents/169155
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