İlhan HACIBEKİROĞLU, Ata Türker ARIKÖK, Uğur ERSOY, Dilşen ÇOLAK, Berkant SÖNMEZ, G. İnanç İMAMOĞLU, Semiha JRVAY, Mustafa ALTINBAŞ, Ünsal HAN

Metastatik meme kanseri hastalarında, primer tümör ve metastazda hormon reseptör ve HER-2 ekspresyon değişiklikleri

Amaç: Bu çalışmada metastatik meme kanseri olgularında primer ve metastaz bölgesinden yapılan biyopsilerde hormon reseptör ve HER-2 ekspresyon değişikliklerinin incelenmesi ve bu konudaki literatürün gözden geçirilmesi amaçlanmıştır. Yöntem ve Gereçler: Kliniğimize Mart 2008 ile Ekim 2011 tarihleri arasında meme kanseri tanısıyla başvuran 242 hastanın dosyaları retrospektif olarak tarandı. Primer ve metastaz bölgesinden biyopsisi olan hastaların dosyaları hormon reseptör ve HER-2 ekspresyon değişiklikleri açısından gözden geçirildi Sonuçlar: Kliniğimizde belirtilen tarihler arasında meme kanserli 275 hastanın takip ve tedavisi uygulanmıştı. Bu hastalardan 34 tanesi metastatik olup, 17 tanesinde hem primer, hem metastaz bölgesinden doku tanısı mevcuttu. Primer ve metastaz bölgesinden immunhistokimyasal boyama yapılan hastaların 12’sinde östrojen reseptörü, 9’unda progesteron reseptörü ve 9’unda HER-2 sonucu mevcuttu. Östrojen reseptörü çalışılan 12 hastanın 8’inde östrojen reseptörü primer ve metastazda benzer iken, 4’ünde (% 33) değişikliğe uğramıştı. Progesteron reseptörü 9 hastanın 4’ünde benzer olup, 5’inde (% 55) değişikliğe uğramıştı. HER-2 durumu değerlendirilen 6 hastanın 4’ünde sonuç benzerken 2 hastada (% 33) değiştiği gözlendi. Tartışma: Meme kanserinde tedavi seçiminde hormon reseptör ve HER-2 durumu önem taşımaktadır. Literatürde metastatik hastalıkta hormon reseptör ve HER-2 ekspresyonunun değiştiğini gösterir çalışmalar mevcuttur. Takipte metastazı gelişen hastalarda metastazdan biyopsi tekrarı, en uygun tedavinin belirlenmesinde önem taşımaktadır.

Hormon receptor and Her-2 status discordance between primary and metastatic lesions in metastatic breast cancer

Aim: In this study, we aim to evaluate differences in estrogen receptor, progesterone receptor, and HER-2 expression in metastatic breast cancer patients on the tissue samples of primary and metastatic lesions Material and Methods: In this study, we reviewed the records of our breast cancer patients between March 2008 and October 2011. The records of patients with metastatic breast cancer whose tissue samples both from primary and metastatic sites were available were included in the study. Results: Analysis was made on 13 patients with metastatic breast cancer whose estrogen receptor, progesterone receptor and HER-2 status were known both on the tissue samples of primary and metastatic lesions. Among 12 patients with known estrogen receptor expression on both primary and metastatic lesions, %33 (n=4) showed discordance. Progesterone receptor expression on both primary and metastatic lesions was changed 5 of 9 patients (55%) Among 9 patients with known HER-2 expression on both primary and metastatic lesions, 22% (n = 2) showed discordance on HER-2 expression. Discussion: As these discordant results make changes in treatment decision, a biopsy of the metastatic lesion could be recommended in patients with metastatic breast cancer when feasible. Larger series are needed to identify the potential effect of prior therapies and site of metastasis on discordant results.

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