Internodal HER2 heterogeneity of axillary lymph node metastases in breast cancer patients

  • Ilija Vladimir Baroš Department of Clinical Pathology, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
  • Nataša Tanasković Lung Clinic, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
  • Ulrika Pellas Pathology and Cytology Dalarna, County Hospital Falun; Center for Clinical Research Dalarna, Falun, Sweden
  • Živka Eri Department of Pathology, Institute for Pulmonary Diseases of Vojvodina, Sremska Kamenica, Serbia
  • Ljiljana Tadić Latinović Department of Clinical Pathology, University Clinical Centre of the Republic of Srpska, Banja Luka, Bosnia and Herzegovina
  • Tibor Tot Pathology and Cytology Dalarna, County Hospital Falun, Falun, Sweden
Keywords: Breast Cancer, HER2, gene protein assay, GPA, tumoral heterogeneity, lymph nodes, metastasis

Abstract

Determination of human epidermal growth factor receptor 2 (HER2) status is important for adequate treatment of breast cancer (BC) patients. The novel HER2 gene protein assay (GPA) is particularly convenient, as it allows the simultaneous assessment of HER2 protein expression and gene amplification at individual cell level. Here we investigated the frequency of internodal HER2 heterogeneity in axillary lymph node macrometastases of BC patients and compared HER2 status between primary breast tumor and its metastases. We included a total of 41 female patients operated between 2014 and 2015 for primary BC with axillary lymph node macrometastases. Representative paraffin blocks of metastatic lymph nodes were sectioned and the slides were stained using the GPA in 38 BC cases. GPA results were assessed according to the ASCO/CAP 2013 criteria. We analyzed 12586 individual tumor cells, 120 cells per section of each metastatic lymph node. HER2 status differed between the primary tumor and its metastases in 5/38 cases (13.2%). In patients with at least two metastatic nodes, the HER2 status of lymph node metastases was only slightly different in 4/23 cases (17.4%). Our results indicate rare but substantial differences in HER2 status between primary breast tumor and its axillary lymph node metastases that may direct the choice and outcomes of targeted therapy in BC patients. The impact of the rare and subtle internodal HER2 heterogeneity evidenced in this study remains uncertain. Determining the HER2 status of lymph node metastases in BC seems to be rational, but assessing a limited number of metastatic nodes may be sufficient.

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Internodal HER2 heterogeneity of axillary lymph node metastases in breast cancer patients
Published
2019-08-20
How to Cite
1.
Baroš IV, Tanasković N, Pellas U, Eri Živka, Tadić Latinović L, Tot T. Internodal HER2 heterogeneity of axillary lymph node metastases in breast cancer patients. Bosn J of Basic Med Sci [Internet]. 2019Aug.20 [cited 2019Nov.21];19(3):242-8. Available from: https://www.bjbms.org/ojs/index.php/bjbms/article/view/3970
Section
Pathology