Changes in expression of breast cancer tumor biomarkers between primary tumors and corresponding metastatic sites: common patterns and relationships with survival.

Lara Schwieger, Lauren M Postlewait, Yi Liu, Stephanie Jou, Sha Yi, Limin Peng, Xiaoxian Li

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Article in Breast cancer research and treatment, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed

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3 citing papers in PubMed.

Multimodal analysis of a rare BARD1 missense variant suggests its pathogenicity is conditional.NPJ breast cancer · 2026
Article
Prognostic value of the systemic immune-inflammation index in recurrent/metastatic triple-negative breast cancer: a retrospective cohort study.Gland surgery · 2025
Article
Deviating HER2 status between primary breast carcinomas and their liver metastases.Frontiers in oncology · 2025
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7 authors.

Lara SchwiegerDivision of Surgical Oncology, Department of Surgery, Grady Memorial Hospital, Emory University, Atlanta, GA, USA.

Lauren M Postlewait *Division of Surgical Oncology, Department of Surgery, Grady Memorial Hospital, Emory University, Atlanta, GA, USA. lauren.postlewait@emory.edu.

Yi LiuDepartment of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA.

Stephanie JouDepartment of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA.

Sha YiDepartment of Pathology and Laboratory Medicine, East Carolina University, Greenville, NC, USA.

Limin PengDepartment of Biostatistics and Bioinformatics, Emory University, Atlanta, GA, USA.

Xiaoxian Li *Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA. xli40@emory.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn metastatic breast cancer, differences in expression patterns of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER2) between the primary tumor (PT) and metastatic site (MET) have been reported. However, there is limited understanding of the relationship of tumor subtype discordance and overall survival (OS). We evaluated patterns of ER/PR/HER2 in PTs and corresponding METs and assessed the relationship between these patterns and OS.

methodsPatients diagnosed at our center with metastatic breast cancer (2011-2020) were included. ER/PR were stratified as < 1%/1-10%/ > 10% by immunohistochemistry and HER2 as positive/negative by immunohistochemistry/FISH. Tumor subtypes were classified as ER or PR + /HER2-, HER2+ , or triple-negative. Biomarker discordance data from PTs to METs were analyzed for expression patterns. OS was assessed.

resultsOf 254 patients, 41 (16.1%) had synchronous and 213 (83.9%) had metachronous METs. Category change of ER/PR/HER2 expression was observed in 56 (22.0%), 117 (40.5%), and 30 (11.8%) patients, respectively. Tumor subtype changed in 56 (22.0%) patients. We identified a difference between PT and MET from ER > 10% to ER < 1% (n = 28,16.2% p < 0.01); PR > 10% to PR < 1% (n = 54,48.2%, p < 0.001); PR > 10% to PR 1-10% (n = 18,16.1%, p < 0.001), and ER or PR+/HER2- to triple-negative (n = 19,13.0%, p = 0.03). In log-rank analysis, change from an ER or PR+/HER2- (5-year OS 88.6%) PT to a HER2+(67.5%) or triple-negative (54.6%) MET was associated with decreased survival (p < 0.01); however, in multivariate analysis, discordant biomarker expression was not associated with decreased survival (p > 0.05).

conclusionTumor expression of ER/PR/HER2 can differ between the PT and MET. Loss of ER/PR expression is common and may be related to worse survival. Routine assessment of MET tumor markers could inform prognosis and therapeutic decision-making.

Indexed as

Biomarkers, TumorBreast NeoplasmsErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenReceptors, ProgesteroneAdultAgedAged, 80 and overFemaleHumansImmunohistochemistryMiddle AgedNeoplasm MetastasisPrognosisBiomarkers, TumorERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenReceptors, ProgesteroneBreast cancerBreast pathologyHormone receptorsMetastasesTumor markers

Identifiers

PMID38780889

DOI10.1016/j.ejca.2014.04.020

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.