Ji Hyun Youk MD, Presenter: Nothing to Disclose

Yun Joo Park MD, PhD, Abstract Co-Author: Nothing to Disclose

Eun Ju Son MD, PhD, Abstract Co-Author: Nothing to Disclose

Hye Mi Gweon MD, Abstract Co-Author: Nothing to Disclose

Jeong-Ah Kim MD, PhD, Abstract Co-Author: Nothing to Disclose

To evaluate the concordance rate of US-guided 14-gauge core needle biopsy (CNB) and surgical specimens for evaluation of ER, PR and HER2 status and to analyze the clinical and radiological features that affects the concordance rate in breast cancer patients with or without neoadjuvant chemotherapy (NAC).

We examined the concordance of histologic types,ER,PgR,HER2 status between CNB and surgical specimens in 56 patients who underwent CNB before treatment and/or surgical excision in our institution between January 2008 and December 2011. We also evaluated their clinical and radiologic findings. The clinical findings included age,lesion size,presence NAC prior to the surgery,axillary node metastasis and histologic grade of the cancer. The radiologic features were assessed for visibility of cancer on mammogram and US features based on BIRADS. The concordance rate of each receptor was compared between CNB and surgical specimen for the collected clinical and radiologic variables by using the x2or Fisher exact test for categoric variables and the independent t-test for continuous variables.

Among 56 patients,29 had NAC prior to the surgery and 27 had surgery without prior NAC. The concordance between CNB and surgery showed almost perfect agreement for ER in both all patients(k=.82, 91%) and surgery group(k=.93, 96%), substantial agreement for ER in NAC group(k=.73, 86%) and PR in both all patients(k=.60, 80%) and surgery group(k=.71, 85%),and moderate agreement for PR in NAC group(k=.50, 76%), HER2 in all patients(k=.59, 80%), surgery group(k=.48, 78%),and NAC group(k=.66, 83%).The concordance rate of cancer histology was 98%(k=.90). The presence of axillary node metastasis showed higher concordance rate of HER2 in NAC group(95%, p=.036). Lesions not visible on mammogram showed higher concordance rate of HER2 in all patients(86%,p=.013) and surgery group(86%,p=.031). Hypoechogenicity on US showed higher PR concordance rate(86%,p=.004).

Concordance rate of CNB and surgical specimens for receptor status was feasible. Lesions not visible on mammogram, hypoechogenicity on US and presence of axillary node metastasis may be helpful for predicting the concordance.

Clinico-radiologic features associated with the concordance of receptor status can give helpful information for predicting the prognosis and can further lead to appropriate selection of NAC regimen.

Youk, J, Park, Y, Son, E, Gweon, H, Kim, J, Comparison of US-guided 14-gauge Core Needle Biopsy and Surgical Specimens for ER, PgR and HER2 Status of Breast Cancer Patients with or without Neoadjuvant Chemotherapy.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12032070.html