Breast Cancer Research and Treatment

, Volume 129, Issue 3, pp 761–765

Acquisition of metastatic tissue from patients with bone metastases from breast cancer

  • J. F. Hilton
  • E. Amir
  • S. Hopkins
  • M. Nabavi
  • G. DiPrimio
  • A. Sheikh
  • S. J. Done
  • D. Gianfelice
  • F. Kanji
  • S. Dent
  • D. Barth
  • N. Bouganim
  • A. Al-Najjar
  • M. Clemons
Preclinical study

DOI: 10.1007/s10549-010-1264-6

Cite this article as:
Hilton, J.F., Amir, E., Hopkins, S. et al. Breast Cancer Res Treat (2011) 129: 761. doi:10.1007/s10549-010-1264-6

Abstract

Biopsies of metastatic tissue are increasingly being performed. Bone is the most frequent site of metastasis in breast cancer patients, but bone remains technically challenging to biopsy. Difficulties with both tissue acquisition and techniques for analysis of hormone receptor status are well described. Bone biopsies can be carried out by either by standard posterior iliac crest bone marrow trephine/aspiration or CT-guided biopsy of a radiologically evident bone metastasis. The differential yield of these techniques is unknown. Results from three prospective studies of similar methodology were pooled. Patients underwent both an outpatient posterior iliac crest bone marrow trephine/aspiration and a CT-guided biopsy of a radiologically evident bone metastasis. Samples were assessed for the presence of malignant cells and where possible also for estrogen (ER) and progesterone receptor (PgR) expression. 40 patients were enrolled. Bone marrow aspiration/trephine biopsy was completed in 39/40 (97.5%) and CT-guided biopsy was completed in 34/40 (85%) of patients. Sufficient tumor cells for hormone receptor analysis were available in 19/39 (48.8%) and 16/34 (47%) of and bone marrow aspiration/trephine and CT-guided biopsies, respectively. Significant discordance in ER and PgR between the primary and the bone metastasis was also seen. Nine patients had tissue available from both bone marrow and CT-guided bone biopsies. ER and PgR concordance between these sites was 100 and 78%, respectively. Performing studies on human bone metastases is technically challenging, with relatively low yields regardless of technique. Given resource issues and similar success rates when comparing both techniques, bone marrow examination may be utilized first and if inadequate tissue is obtained, CT-guided biopsies can then be used.

Keywords

Metastatic breast cancerHormone receptor discordanceBone metastases

Abbreviations

ER

Estrogen receptor

PgR

Progesterone receptor

HER2

Human epidermal growth factor receptor 2

IHC

Immunohistochemistry

FISH

Fluorescent in-situ hybridization

Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  • J. F. Hilton
    • 1
  • E. Amir
    • 2
  • S. Hopkins
    • 3
  • M. Nabavi
    • 4
  • G. DiPrimio
    • 5
  • A. Sheikh
    • 5
  • S. J. Done
    • 6
  • D. Gianfelice
    • 7
  • F. Kanji
    • 1
  • S. Dent
    • 1
  • D. Barth
    • 2
  • N. Bouganim
    • 1
  • A. Al-Najjar
    • 1
  • M. Clemons
    • 1
  1. 1.Division of Medical Oncology, The Ottawa Hospital Cancer CentreUniversity of OttawaOttawaCanada
  2. 2.Division of Hematology and Medical Oncology, The Princess Margaret HospitalUniversity of TorontoMississaugaCanada
  3. 3.Department of Pharmacy, The Ottawa HospitalUniversity of OttawaOttawaCanada
  4. 4.Department of Pathology, The Ottawa HospitalUniversity of OttawaOttawaCanada
  5. 5.Department of Radiology, The Ottawa HospitalUniversity of OttawaOttawaCanada
  6. 6.Laboratory Medicine ProgramUniversity of TorontoOttawaCanada
  7. 7.Department of Radiology, The Princess Margaret HospitalUniversity of TorontoMississaugaCanada