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Investigating the role of core needle biopsy in evaluating tumor-stroma ratio (TSR) of invasive breast cancer: a retrospective study

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Abstract

Purpose

Tumor-stroma ratio (TSR) of invasive breast carcinoma has gained attention in recent years due to its prognostic significance. Previous studies showed TSR is a potential biomarker for indicating the tumor response to neoadjuvant chemotherapy. However, it is not clear how well TSR evaluation in biopsy specimens might reflect the TSR in resection specimens. We conducted a study to investigate whether biopsy evaluation of TSR can be an alternative method.

Method

We collected cases with invasive breast carcinoma of no special type (IBC-NST) from University of Yamanashi hospital between 2011 and 2017 whose biopsy and resection specimens both had a pathologically diagnosis of IBC-NST (n = 146). We conceptualized a method for evaluating TSR in biopsy specimens within a preliminary cohort (n = 50). Within the studied cohort (n = 96), biopsy-based TSR (b-TSR) and resection-based TSR (r-TSR) were scored by two pathologists. We then evaluated our method’s validity and performance by measuring interobserver variability between the two pathologists, Spearman’s correlation between b-TSR and r-TSR, and the receiver operating characteristics (ROC) analysis for defining stroma-rich and stroma-poor tumors.

Results

Intra-class coefficient between the two pathologists was 0.59. The correlation coefficients between b-TSR and r-TSR in the two pathologists were 0.45 and 0.37. The ROC areas under the curve were 0.7 and 0.67. By considering an r-TSR of < 50% as stroma-rich, the sensitivity and specificity of detecting stroma-rich tumors were 64.1% and 66.7%, respectively, when b-TSR was < 40%.

Conclusion

Our current b-TSR evaluation method can provide information about r-TSR and facilitate pre-treatment therapy follow-up.

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Data availability

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

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Acknowledgements

We thank Dr. Pam Zaber for her works in English editing.

Funding

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

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Author notes

  1. Minh-Khang Le and Toru Odate have contributed equally to this work.

Authors and Affiliations

  1. Department of Pathology, University of Yamanashi, Yamanashi, 409-3898, Japan

    Minh-Khang Le, Toru Odate, Masataka Kawai, Naoki Oishi & Tetsuo Kondo

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  1. Minh-Khang Le
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  2. Toru Odate
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  3. Masataka Kawai
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  4. Naoki Oishi
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  5. Tetsuo Kondo
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by M-KL and TO. The first draft of the manuscript was written by M-KL and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Tetsuo Kondo.

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Competing interest

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

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of the University of Yamanashi (Approval number: 2547, date of issue: 4th January 2022).

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Le, MK., Odate, T., Kawai, M. et al. Investigating the role of core needle biopsy in evaluating tumor-stroma ratio (TSR) of invasive breast cancer: a retrospective study. Breast Cancer Res Treat 197, 113–121 (2023). https://doi.org/10.1007/s10549-022-06768-0

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