ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2019
Breast cancer global tumor biomarkers: a quality assurance study of intratumoral heterogeneity.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
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Who cites it
21 citing papers in PubMed, 35 citations in OpenAlex.
- Intratumor immune heterogeneity across simulated core biopsy sizes in non-small cell lung cancer: an exploratory study.Translational lung cancer research · 2026Article
- Uptake Patterns of [Cancers · 2026Article
- Pathologic features and biomarker profiles of microinvasive breast carcinoma diagnosed on core needle biopsy with excision correlation.Virchows Archiv : an international journal of pathology · 2026Article
- Reliability of core needle biopsy for HER2-low early-stage breast cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2025Article
- HER2 and hormone receptor conversion after neoadjuvant therapy for breast cancer.Frontiers in oncology · 2025Article
- Comparing core needle biopsy and surgical excision in breast cancer diagnosis: implications for clinical practice from a retrospective cohort study.Quantitative imaging in medicine and surgery · 2024Article
- Article
- Comparison of the Structural, Cytological and Biomarker Expression in Carcinoma in situ and Invasive Components in Breast Carcinoma.Iranian journal of pathology · 2024Article
- Article
- Significance of RCC2, Rac1 and p53 Expression in Breast Infiltrating Ductal Carcinoma; An Immunohistochemical Study.Iranian journal of pathology · 2024Article
- Dynamic 2-deoxy-D-glucose-enhanced multispectral optoacoustic tomography for assessing metabolism and vascular hemodynamics of breast cancer.Photoacoustics · 2023Article
- Concordance of immunohistochemistry for predictive and prognostic factors in breast cancer between biopsy and surgical excision: a single-centre experience and review of the literature.Breast cancer research and treatment · 2023Review
- Concordance of breast cancer biomarker testing in core needle biopsy and surgical specimens: A single institution experience.Cancer medicine · 2022Article
- Systematically higher Ki67 scores on core biopsy samples compared to corresponding resection specimen in breast cancer: a multi-operator and multi-institutional study.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2022Article
- Understanding breast cancer heterogeneity through non-genetic heterogeneity.Breast cancer (Tokyo, Japan) · 2021Review
- Morphological intratumor heterogeneity in ductal carcinoma in situ of the breast.Virchows Archiv : an international journal of pathology · 2021Article
- Article
- Association of Preoperative Serum Levels of CEA and CA15-3 with Molecular Subtypes of Breast Cancer.Disease markers · 2021Article
- Intratumoral heterogeneity of second-harmonic generation scattering from tumor collagen and its effects on metastatic risk prediction.BMC cancer · 2020Article
- Changing patterns and survival improvements of young breast cancer in China and SEER database, 1999Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2019Article
Corrections and comments
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Biomarker analysis of invasive breast carcinoma is useful for prognosis, as surrogate for molecular subtypes of breast cancer, and prediction of response to adjuvant and neoadjuvant systemic therapies. Breast cancer intratumoral heterogeneity is incompletely studied. Comprehensive biomarker analysis of estrogen receptor (ER), progesterone receptor (PR), HER2, and Ki67 labeling index was performed on each tissue block of 100 entirely submitted breast tumors in 99 patients. Invasive carcinoma and in situ carcinoma was scored using semiquantitative histologic score (H-score) for ER and PR, HER2 expression from 0 to 3+, and percentage positive cells for Ki67. Core biopsy results were compared with surgical excision results, invasive carcinoma was compared with in situ carcinoma, and interblock tumoral heterogeneity was assessed using measures of dispersion (coefficient of variation and quartile coefficient of dispersion). Overall concordance between core biopsy and surgical excision was 99% for ER and 95% for PR. Mean histologic score of ER was significantly lower in invasive carcinoma between core biopsy and surgical excision (p = 0.000796). Intratumoral heterogeneity was higher for PR than for ER (mean coefficient of variation for ER 0.08 stdv 0.13 vs. PR 0.26 stdv 0.41). Ki67 labeling index was significantly higher in invasive carcinoma as compared with associated ductal carcinoma in situ on surgical resection specimen (p ≤ 0.0001). Ki67 hotspots were identified in 47% of cases. Of 52 HER2 negative cases on core biopsy, 10 were scored as equivocal on surgical resection. None (0/10) were amplified by Her-2/neu fluorescence in situ hybridization. Overall, biomarkers on core biopsy showed concordance with the surgical excision specimen in the vast majority of cases. Biomarker expression of in situ closely approximates associated invasive carcinoma. Intratumoral heterogeneity of PR is greater than ER. Biomarker expression on diagnostic core biopsy or single tumor block is representative of breast carcinoma as a whole in most cases and is appropriate for clinical decision-making.
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