Estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) immunohistochemistry are important markers in the management of patient with breast carcinoma. In this study, we determine the concordance rate of ER, PR and HER2 immunohistochemistry markers between core needle biopsy (CNB) and excisional biopsy (EB) of breast carcinoma in patients of Universiti Kebangsaan Malaysia Medical Centre (UKMMC) from January 2002 until December 2012. A total of 93 female patients with CNB and subsequent EB were included in this retrospective descriptive study. Immunohistochemistry is used to determine ER, PR and HER2. ER and PR was graded using Allred score (0 to 8) while HER2 was scored from 0 to 3+. The markers between these two biopsies were compared to determine the concordance rate. In ER and PR, 93 samples were compared. ER was concordant in 80 cases (86.0%) and 13 cases (14.0%) was discordant. PR was concordant in 82 cases (88.2%) and discordant in 11 cases (11.8%). In HER2, 87 samples were compared and 62 cases (71.3%) were concordant while 25 cases (28.7%) were discordant. Concordance between CNB and EB was high for ER and PR. However, concordance rate for HER2 immunohistochemistry was less consistent. Overall, immunohistochemical analyses of CNB reflect the tumour marker status of the excised specimen.
Comparison of Immunohistochemical Markers in Core Needle Biopsy and Excisional Biopsy in Breast Carcinoma
Author
Abstrak
Reseptor estrogen (ER), reseptor progesterone (PR) dan reseptor faktor ketumbuhan epidermal manusia 2 (HER2) immunohistokimia adalah penanda penting dan berperanan di dalam pengurusan pesakit yang menghidap neoplastik payudara. Di dalam kajian ini, kami membandingkan kadar konkordan ER, PR, dan HER2 diantara biopsi jarum teras dan biopsi eksais pada tisu neoplastik payudara melibatkan pesakit pesakit Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM) yang di diagnosa diantara bulan Januari 2002 sehingga Disember 2012. Seramai 93 pesakit wanita yang menjalani biopsi jarum teras dan kemudiannya biopsi eksais termasuk di dalam kajian retrospektif ini. Kajian immunohistokimia telah digunakan untuk menentukan pewarnaan ER, PR dan HER2. Pewarnaan ER dan PR telah dianalisa menggunakan skor Allred (0 hingga 8) manakala analisa pewarnaan HER2 menggunakan sistem skor 0 hingga 3+. Skor keputusan dibanding antara kedua biopsy tersebut untuk menentukan kadar konkordan. Sebanyak 93 sampel berjaya dibandingkan diantara kedua biopsi tersebut untuk pewarnaan immunohistokimia ER dan PR. Kadar konkordan ER adalah sebanyak 80 kes (86%) dan 13 kes (14%) bagi yang tidak konkordan. Kadar konkordan PR adalah sebanyak 82 kes (88.2%) dan 11 kes (11.8%) bagi yang tidak konkordan. Sebanyak 87 sampel telah dibandingkan untuk kajian pewarnaan immunohistokima HER2 dan kadar konkordan adalah sebanyak 62 kes (71.3%) dan 25 kes (28.7%) bagi yang tidak konkordan. Di dalam kajian ini, kadar konkordan diantara biopsi tisu jarum teras dan biopsi eksais bagi ER dan PR adalah tinggi. Manakala, kadar konkordan untuk pewarnaan HER2 adalah kurang konsisten. Kesimpulannya, analisa immunohistokimia untuk biopsi tisu jarum teras dapat meramal keputusan penanda pada tisu biopsy eksais di dalam penyakit neoplastik payudara.
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