Evidence map›Paper›PMID 42329472›Full record

ArticleBreast cancer research and treatment2026

Receptor discordance between primary tumors and nodal metastases and correlation with the 21-gene recurrence score in early-stage, estrogen receptor-positive, node-positive breast cancer.

Serena Zheng, Peggy Sullivan, Kumkum Vadehra, Jiyoon Kim, Alexis Levee, Rena Callahan, Mediget Teshome, Chi-Hong Tseng, Aditya Bardia, Nimmi S Kapoor

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Breast cancer research and treatment, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Serena ZhengDepartment of Surgery, University of California Los Angeles, 10833 Le Conte Ave. 54-117 CHS, Los Angeles, CA, 90095, USA.
Peggy SullivanDepartment of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Kumkum VadehraDepartment of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Jiyoon KimDepartment of Biostatistics, University of California Los Angeles, Los Angeles, CA, USA.
Alexis LeveeDepartment of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Rena CallahanDepartment of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Mediget TeshomeDepartment of Surgery, University of California Los Angeles, 10833 Le Conte Ave. 54-117 CHS, Los Angeles, CA, 90095, USA.
Chi-Hong TsengDepartment of Biostatistics, University of California Los Angeles, Los Angeles, CA, USA.
Aditya BardiaDepartment of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Nimmi S KapoorDepartment of Surgery, University of California Los Angeles, 10833 Le Conte Ave. 54-117 CHS, Los Angeles, CA, 90095, USA. NSKapoor@mednet.ucla.edu.ORCID https://orcid.org/0009-0002-4572-075X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn estrogen receptor (ER)-positive, HER2-negative breast cancer, systemic therapy decisions are often made on the biomarker status of the primary tumor, along with the Oncotype DX Recurrence Score

methodsWe conducted a retrospective study of women with stage II-III, ER-positive, HER2-negative, node-positive invasive breast cancer who underwent upfront surgery and Oncotype DX testing of the primary tumor between 2016 and 2020. ER, PR, and HER2 immunohistochemistry (IHC) was performed on archived nodal metastases. Discordance in ER/PR percent positivity and HER2 IHC score between primary and lymph node metastases was scored ordinally from 0 to 2 for no, mild, or marked difference, respectively. Associations with RS, tumor and nodal burden, and treatment were analyzed using standard parametric and nonparametric tests with statistical significance set at p < 0.05.

resultsOf 555 patients with RS testing, 91 patients met inclusion criteria and 73 had available nodal tissue. Discordance in at least one receptor was high overall, occurring in 56/73 (77%) cases. The discordance rate for ER was 15%, PR was 32%, and HER2 was 66% (58% mild, 8% marked). One case demonstrated loss of ER positivity in the node, and 14 demonstrated loss of PR positivity in the node; no primary HER2-negative tumor converted to HER2-positive (IHC 3+) disease in the node. Greater amount of HER2 discordance was associated with larger primary tumors and larger size of nodal metastatic deposits. Higher RS correlated with lower primary ER and PR expression and higher volume of nodal burden (p < 0.05 for each) but was not significantly associated with receptor discordance.

conclusionsReceptor discordance between primary tumors and nodal metastases is common, with most shifts occurring within the HER2-spectrum. There was a trend toward higher RS and ER or HER2-receptor discordance. HER2 discordance was also associated with larger tumor size and larger size of nodal metastasis. As strategies emerge to target HER2-low cohorts and to include ER-low/HER2-negative disease within treatment regimens for TNBC, it may become important to consider receptor testing of nodal disease in the future.

Indexed as

Biomarkers, TumorBreast NeoplasmsErb-b2 Receptor Tyrosine KinasesNeoplasm Recurrence, LocalReceptors, EstrogenReceptors, ProgesteroneAdultAgedFemaleHumansImmunohistochemistryLymphatic MetastasisLymph NodesMiddle AgedNeoplasm StagingRetrospective StudiesBiomarkers, TumorERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenReceptors, Progesterone

Identifiers

PMID42329472
PMCPMC13287169

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.