Breast Cancer Research and Treatment

, Volume 171, Issue 2, pp 295–302 | Cite as

Comparison of tumor-infiltrating lymphocytes of breast cancer in core needle biopsies and resected specimens: a retrospective analysis

  • Yoon Jin Cha
  • Sung Gwe Ahn
  • Soong June Bae
  • Chang Ik Yoon
  • Jayeong Seo
  • Woo Hee Jung
  • Eun Ju Son
  • Joon JeongEmail author
Preclinical study



Neoadjuvant chemotherapy (NAC) is being increasingly used to treat locally advanced breast cancer and to conserve the breast. In triple-negative breast cancer and HER2-positive breast cancer, a high density of tumor-infiltrating lymphocytes (TILs) is an important predictor of NAC response. Thus far, it remains unclear whether the TIL scores in core needle biopsies (CNBs) are closely representative of those in the whole tumor section in resected specimens. This study aimed to evaluate the concordance between the TIL scores of CNBs and resected specimens of breast cancer.


A total of 220 matched pairs of CNBs and resected specimens of breast cancer were included. Stromal TILs were scored on slides stained with hematoxylin and eosin. Clinicopathologic parameters and the agreement of the TIL scores between CNBs and resected specimens were statistically analyzed.


The average TIL score was approximately 4.4% higher for the resected specimens than for the CNBs. When the tumors were divided into two groups according to a 60% TIL score cut-off (low and intermediate TIL vs. high TIL), 8.2% showed discordance between the CNB and resected specimen. The overall intraclass correlation coefficient (ICC) value of the TIL score was 0.895 (95% confidence interval, 0.864–0.920, P < 0.001), and all molecular subtypes showed ICC values over 0.8 (P < 0.001). The ICC values were > 0.9 when ≥ 5 cores were included in the CNBs. Tumors with discordant TILs were characterized by histologic grade III, ER negativity, high proliferative index, and HER2 and triple-negative subtypes. A high proliferative index was an independent risk factor for TIL discordance.


The TIL score in CNB specimens is a reliable value that reflects the TIL status of the entire tumor in resected specimens of breast cancer. More than five CNB cores may accurately predict the TIL score of the entire tumor.


Lymphocytes, Tumor-infiltrating Breast neoplasms Core needle biopsy Mastectomy, Segmental Mastectomy, Modified radical Neoadjuvant therapy 



Confidence interval


Core needle biopsies


Estrogen receptor


Hematoxylin and eosin


Human epidermal growth factor receptor-2


Intraclass correlation coefficient


Labeling index


Neoadjuvant chemotherapy


Progesterone receptor


Triple-negative breast cancer


Tumor-infiltrating lymphocytes



The authors are deeply indebted to Hye Sun Lee, PhD, Biostatistics Collaboration Unit, Yonsei University College of Medicine, for her insightful comments that greatly improved the manuscript.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

Supplementary material

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Yoon Jin Cha
    • 1
  • Sung Gwe Ahn
    • 2
  • Soong June Bae
    • 2
  • Chang Ik Yoon
    • 2
  • Jayeong Seo
    • 1
  • Woo Hee Jung
    • 1
  • Eun Ju Son
    • 3
  • Joon Jeong
    • 2
    Email author
  1. 1.Department of Pathology, Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea
  2. 2.Department of Surgery, Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea
  3. 3.Department of Radiology, Gangnam Severance HospitalYonsei University College of MedicineSeoulRepublic of Korea

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