The discordance of biomarkers in primary tumour and synchronous axillary lymph node metastasis of the breast cancer, and its clinical significance in patients undergoing neoadjuvant therapy

Sanal A. K., Turan U., Yugruk A., Taş Z. A., Irkorucu O., TAŞKIN Ö.

Expert Review of Anticancer Therapy, 2025 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Publication Date: 2025
  • Doi Number: 10.1080/14737140.2025.2464199
  • Journal Name: Expert Review of Anticancer Therapy
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Keywords: Breast cancer, chemotherapy, estrogen receptor, HER-2, Ki-67, progesterone receptor
  • Çukurova University Affiliated: Yes

Abstract

Background: This study explores the disparity in ER, PR, HER-2, and Ki-67 status between primary breast tumors (PBT) and axillary lymph node metastasis (ALNM) at initial admission in patients undergoing neoadjuvant chemotherapy (NAC). Research design and methods: Demographic-clinicopathological characteristics and histopathological response to NAC in both PBT and ALNM were recorded. Immunohistochemical analysis of ER, PR, HER-2, and Ki67 was performed separately in PBT and ALNM, with discordance rates compared. The disparity in biomarkers was assessed in relation to the histopathological response to NAC in both PBT and ALNM. Results: In 96 female patients, discordance rates between PBT and ALNM were 16.67% for ER, 16.67% for PR, 20.83% for HER-2, and 15.63% for Ki-67. Statistically significant differences in ER and PR discordance between PBT and ALNM were observed. Additionally, a significant difference in histopathological response to NAC was noted based on ER discordance. Conclusion: Precise assessment of ER and HER-2 status in axillary lymph node biopsy specimens is crucial in breast cancer patients with ALNM, potentially optimizing systemic and surgical treatment selection.