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Concordance between core needle biopsy and surgical excision for breast cancer tumor grade and biomarkers

  • Epidemiology
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Purpose

Histopathological biomarkers guide breast cancer management. Testing histopathological biomarkers on both core needle biopsy (CNB) and surgical excision (SE) in patients who are treated with upfront surgery is unnecessary and costly if there is high concordance between the two. This study investigated the concordance between CNB and SE for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor-2 (HER2), tumor grade and Ki-67.

Methods

Histopathological biomarker information were retrospectively collected from preoperative CNB and SE on patients diagnosed with breast cancer through the BreastScreen Sydney West program over a four-year period between January 2017 and December 2020. Data were then analyzed to calculate percentage of agreement and concordance using kappa values for ER, PR, HER2, tumor grade and Ki-67.

Results

A total of 504 cases of invasive breast cancers were analyzed. There was substantial level of concordance for ER 96.7% (κ = 0.687) and PR 93.2% (κ = 0.69). Concordance for HER2 negative (IHC 0, IHC 1 +) or positive (IHC 3 +) tumor on CNB was 100% (κ = 1.00). Grade and Ki-67 showed moderate level of concordance, 72.6% (κ = 0.545) and 70.5% (κ = 0.453), respectively.

Conclusion

ER, PR and HER2 show high level of concordance. CNB is reliable in determining histopathological biomarkers for ER, PR positive and HER2 positive or negative tumors indicating that retesting these on SE may not be necessary.

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Data availability

The datasets generated during and/or analyzed during the current study are not publicly available due to ethics requirements but are available from the corresponding author on reasonable request.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

Author information

Authors and Affiliations

  1. Western Sydney Local Health District, Sydney, Australia

    Aswin Shanmugalingam, Kerry Hitos, Shrenik Hegde, Ali Al-Mashat, Nirmala Pathmanathan & Nicholas K. Ngui

  2. Westmead Breast Cancer Institute, Westmead Hospital, Sydney, Australia

    Nirmala Pathmanathan & Nicholas K. Ngui

  3. Nepean Blue Mountains Local Health District, Sydney, Australia

    Senarath Edirimmane

  4. Northern Surgical Oncology, Sydney, Australia

    Senarath Edirimmane, T Michael Hughes & Nicholas K. Ngui

  5. Sydney Medical School, University of Sydney, Sydney, Australia

    Kerry Hitos & Senarath Edirimmane

  6. Australian National University, Canberra, Australia

    T Michael Hughes

  7. Sydney Adventist Hospital, Sydney, Australia

    Senarath Edirimmane, T Michael Hughes & Nicholas K. Ngui

  8. Department of Surgery, Blacktown and Mount Druitt Hospitals, 75 Railway St, Mount Druitt, Sydney, NSW, 2770, Australia

    Nicholas K. Ngui

Authors
  1. Aswin Shanmugalingam
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  2. Kerry Hitos
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  3. Shrenik Hegde
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  4. Ali Al-Mashat
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  7. T Michael Hughes
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  8. Nicholas K. Ngui
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Contributions

NN and TMH: contributed to the study conception and design. Material preparation, data collection and analysis were performed by AS, KH, SH and AAM. The first draft of the manuscript was written by AS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Nicholas K. Ngui.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This is study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Western Sydney Local Health District Human Research Ethics Committee.

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Shanmugalingam, A., Hitos, K., Hegde, S. et al. Concordance between core needle biopsy and surgical excision for breast cancer tumor grade and biomarkers. Breast Cancer Res Treat 193, 151–159 (2022). https://doi.org/10.1007/s10549-022-06548-w

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  • DOI: https://doi.org/10.1007/s10549-022-06548-w

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