engleski

THE EFFECT OF CHEMOTHERAPY ON CHANGES OF HORMONE RECEPTORS AND HER-2 STATUS IN BREAST CANCER

Objectives: To compare the immunohistochemical expression of ER, PR and HER-2 between the primary breast cancer (PBC) and matched metastatic lesions (MML) and find out the degree of discordance. Primary breast cancer is treated according to its ER, PR and HER-2 receptor statuses. The same parameters are carried out in patients who develop metastatic disease after treatment. Since the receptor status of the metastatic lesions may occasionally change after treatment it is crucial to know how frequently that change can occur Materials and Methods: Study included 52 patients with local recurrence or cutaneous metastases of breast cancer developed after adjuvant therapy. Out of 52 tumor tissue samples, 31 were hormone receptors positive and 21 were hormone receptors negative. Immunohistochemical expression of ER, PR and HER-2 receptors statuses was reevaluated on biopsy material of metastatic lesions available from archive at pathology department. Results: Among 21 cases of hormone receptors negative PBC, we have found complete change of negative PBC to hormone receptor positive MML in five cases (23.8%). In the same group, HER-2 status was changed in two cases (9.5%). The change went in both directions, from negative PBC to positive MML and from positive PBC to negative MML while four cases with HER-2 positivity in PBC remained positive in MML. Although, among 31 cases of hormone positive PBC, ER changed from positive to negative in seven cases (22.6%) and PR changed from positive to negative in ten cases (32.3%), it did not influence on overall change of hormone receptor status. We have found complete change of hormone positive PBC to hormone negative MML in seven cases (22.6%).In this group, HER-2 negative PBC became positive in two cases and one HER-2 positive PBC changed to negative MML. Overall discordance in hormone receptor status between 52 cases of PBC and MML was observed in twelve cases (23.1%) and discordance in HER-2 status was observed in five cases (9.6%). Conclusion: 32.7% of MML developed after adjuvant therapyshowed radical change in ER, PR or HER- 2 status compared to the primary tumor. These findings should to be considered in decision about further metastatic breast cancer treatment.

HORMONE RECEPTORS, HER-2, BREAST CANCER, CHEMOTHERAPY

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