BACKGROUND/OBJECTIVE: Hormone receptor (HR) status is one of the key factors in determining the treatment of breast cancer. Previous studies suggested that HR status may change in metastatic tissue. However, available studies focused mainly on primary biopsies and there are only few trials comparing HR status in the primary tumour and the metastasis using material from complete resection. The aim of the study was to determine the frequency of HR alterations in metastatic breast cancer. MATERIALS AND METHODS: The study retrospectively examines a total of 50 patients who underwent brain, lung, or liver metastasectomy for metastatic breast cancer between January 2000 and January 2019. RESULTS: HR conversion was observed in a total of 30 cases (60.0%), while HER-2/neu (human epidermal growth factor receptor 2) discrepancy surprisingly occurred only in one case (2.0%). A change in immunophenotype occurred in 28% of cases. Triple-negativity was more frequent in brain metastases (p = 0.039). CONCLUSIONS: We have confirmed that HR conversion between the primary tumour and its metastases occurs in a significant number of cases, which has important implications for further treatment decisions.

Biomedical Center Faculty of Medicine in Pilsen Charles University Pilsen Czech Republic

Department of Neurology Charles University and University Hospital Pilsen Czech Republic

Department of Neurosurgery Charles University and University Hospital Pilsen Czech Republic

Department of Oncology and Radiotherapy Charles University and University Hospital Pilsen Czech Republic

Department of Pathology Charles University and University Hospital Pilsen Czech Republic

Department of Surgery Charles University and University Hospital Pilsen Czech Republic

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Gradishar WJ, Anderson BO, Abraham J, et al. Breast Cancer, Version 3.2020, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2020;18(4):452–478. doi: 10.6004/jnccn.2020.0016. PubMed DOI

Cardoso F, Paluch-Shimon S, Senkus E, et al. 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) Ann Oncol. 2020;31(12):1623–1649. doi: 10.1016/j.annonc.2020.09.010. PubMed DOI PMC

Nishimura R, Osako T, Okumura Y, et al. Changes in the ER, PgR, HER2, p53 and Ki-67 biological markers between primary and recurrent breast cancer: discordance rates and prognosis. World J Surg Oncol. 2011;9:131. doi: 10.1186/1477-7819-9-131. PubMed DOI PMC

Hoefnagel LDC, van de Vijver MJ, van Slooten HJ, et al. Receptor conversion in distant breast cancer metastases. Breast Cancer Res. 2010;12(5):R75. doi: 10.1186/bcr2645. PubMed DOI PMC

Amir E, Miller N, Geddie W, et al. Prospective study evaluating the impact of tissue confirmation of metastatic disease in patients with breast cancer. J Clin Oncol. 2012;30(6):587–592. doi: 10.1200/JCO.2010.33.5232. PubMed DOI PMC

Ibrahim T, Farolfi A, Scarpi E, et al. Hormonal receptor, human epidermal growth factor receptor-2, and Ki67 discordance between primary breast cancer and paired metastases: clinical impact. Oncology. 2013;84(3):150–157. doi: 10.1159/000345795. PubMed DOI

Curtit E, Nerich V, Mansi L, et al. Discordances in estrogen receptor status, progesterone receptor status, and HER2 status between primary breast cancer and metastasis. Oncologist. 2013;18(6):667–674. doi: 10.1634/theoncologist.2012-0350. PubMed DOI PMC

Chen R, Qarmali M, Siegal GP, et al. Receptor conversion in metastatic breast cancer: analysis of 390 cases from a single institution. Mod Pathol. 2020;33(12):2499–2506. doi: 10.1038/s41379-020-0615-z. PubMed DOI

Dieci MV, Barbieri E, Piacentini F, et al. Discordance in receptor status between primary and recurrent breast cancer has a prognostic impact: a single-institution analysis. Ann Oncol. 2013;24(1):101–108. doi: 10.1093/annonc/mds248. PubMed DOI

Shin HC, Han W, Moon HG, et al. Patients with Concordant Triple-Negative Phenotype between Primary Breast Cancers and Corresponding Metastases Have Poor Prognosis. J Breast Cancer. 2016;19(3):268–274. doi: 10.4048/jbc.2016.19.3.268. PubMed DOI PMC

Woo JiW, Chung YRi, Ahn S, et al. Changes in Biomarker Status in Metastatic Breast Cancer and Their Prognostic Value. J Breast Cancer. 2019;22(3):439–452. doi: 10.4048/jbc.2019.22.e38. PubMed DOI PMC

Cameron JL, Cameron AM. Current Surgical Therapy. 13th ed. Elsevier; 2020.

Allott EH, Geradts J, Sun X, et al. Intratumoral heterogeneity as a source of discordance in breast cancer biomarker classification. Breast Cancer Res. 2016;18(1):68. doi: 10.1186/s13058-016-0725-1. PubMed DOI PMC

Perez EA, Suman VJ, Davidson NE, et al. HER2 testing by local, central, and reference laboratories in specimens from the North Central Cancer Treatment Group N9831 intergroup adjuvant trial. J Clin Oncol. 2006;24(19):3032–3038. doi: 10.1200/JCO.2005.03.4744. PubMed DOI

Schrijver WA, Suijkerbuijk KPM, van Gils CH, et al. Receptor Conversion in Distant Breast Cancer Metastases: A Systematic Review and Meta-analysis. J Natl Cancer Inst. 2018;110(6):568–580. doi: 10.1093/jnci/djx273. PubMed DOI

Jung J, Lee SH, Park M, et al. Discordances in ER, PR, and HER2 between primary breast cancer and brain metastasis. J Neurooncol. 2018;137(2):295–302. doi: 10.1007/s11060-017-2717-0. PubMed DOI PMC

Bachmann C, Grischke EM, Staebler A, et al. Receptor change-clinicopathologic analysis of matched pairs of primary and cerebral metastatic breast cancer. J Cancer Res Clin Oncol. 2013;139(11):1909–1916. doi: 10.1007/s00432-013-1511-4. PubMed DOI

Aurilio G, Disalvatore D, Pruneri G, et al. A meta-analysis of oestrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 discordance between primary breast cancer and metastases. Eur J Cancer. 2014;50(2):277–289. doi: 10.1016/j.ejca.2013.10.004. PubMed DOI

ProchÁzkovÁ K, PivovarČÍkovÁ K, RouŠarovÁ M, et al. Prognostic Factors After Surgical Treatment of Liver Metastases from Breast Cancer — 19 Years of Experience. In Vivo. 2021;35(1):417–422. doi: 10.21873/invivo.12273. PubMed DOI PMC

Yamanouchi K, Kuba S, Eguchi S. Hormone receptor, human epidermal growth factor receptor-2, and Ki-67 status in primary breast cancer and corresponding recurrences or synchronous axillary lymph node metastases. Surg Today. 2020;50(7):657–663. doi: 10.1007/s00595-019-01831-8. PubMed DOI