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Prognostic impact of discordance/concordance of triple-receptor expression between primary tumor and metastasis in patients with metastatic breast cancer



Prognostic impact of discordance/concordance of triple-receptor expression between primary tumor and metastasis in patients with metastatic breast cancer



Journal of Clinical Oncology 26(15_Suppl): 1001-1001



NlmCategory="UNASSIGNED">1001 Background: Triple-negative breast cancer (TNBC) lacks expression of estrogen receptor (ER), progesterone receptor (PR) and HER2 expression and carries an unfavorable prognosis. It has been hypothesized that expression status of these three features might change during disease course. We studied discordance of triple receptor status between primary tumor (T) and metastasis (M) in 789 patients who were diagnosed with metastatic breast cancer. ER, PR and HER2 status were determined by immunohistochemistry and/or fluorescence-in-vitro hybridization. Expression status for ER, PR and HER2 in both T and M was known in 228 (28.9%), 218 (27.6%) and 528 (70.0%) cases, respectively. Cases with TNBC were compared to cases expressing at least one receptor. Discordance was correlated to clinical/pathological parameters, site of recurrence and overall survival (OS). Discordance rates for ER, PR, HER2, and TNBC are given ( Table ). Loss of receptor expression occurred more often than gain thereof. Discordance of ER, PR or HER2 expression was not associated with size, stage or histologic grade of the primary tumor. HER2 concordance was associated with bone as opposed to visceral/soft tissue recurrence. For both ER and PR, positivity in both T and M was associated with better OS compared to negative expression in at least one. HER2 discordance was associated with better OS compared to patients with HER2 concordance (p = 0.029). Patients with TNBC discordance had worse OS compared to patients with TNBC concordance (p = 0.002). After adjustment for clinical/pathological parameters, these associations remained independent. Discordance in triple-receptor expression between primary tumor and metastasis carries a worse prognosis compared to concordance. [Table: see text] No significant financial relationships to disclose.

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Accession: 058636391

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PMID: 27951388


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