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HER2 Expression in Fine Needle Aspirates of Lymph Nodes Detected by Preoperative Axillary Ultrasound in Breast Cancer Patients

Authors
 Ji Soo Choi  ;  Hyun Ok Kim  ;  Eun-Kyung Kim  ;  Young Joo Suh  ;  Jung Hyun Yoon  ;  Hee Jung Moon  ;  Min Jung Kim 
Citation
 PLOS ONE, Vol.9(11) : e113065, 2014 
Journal Title
 PLOS ONE 
Issue Date
2014
MeSH
Adult ; Aged ; Biopsy, Fine-Needle ; Breast Neoplasms/diagnostic imaging* ; Breast Neoplasms/metabolism* ; Female ; Gene Expression Regulation, Neoplastic* ; Humans ; Lymph Nodes/metabolism ; Lymph Nodes/pathology ; Lymphatic Metastasis ; Middle Aged ; Receptor, ErbB-2/biosynthesis* ; Ultrasonography
Abstract
The purpose of this study was to assess the usefulness of HER2 levels in ultrasonographically guided fine-needle aspiration biopsy (US-FNA) aspirates of axillary lymph nodes (ALNs) in the determination of lymph node metastasis or the characterization of primary breast cancer, and to correlate the HER2 levels in US-FNA aspirates (FNA-HER2s) of metastatic ALNs with the HER2 statuses of corresponding primary breast cancers. An institutional review board approved the study. Between January and October 2010, 164 patients with 167 ALNs examined by US-FNA were included. FNA-HER2s of ALNs were measured by chemiluminescence immunoassay, and they were correlated with cytologic/final diagnoses. Receiver operating characteristics (ROC) curve analysis was performed to evaluate the diagnostic ability to differentiate benign and metastatic ALNs. Additionally, FNA-HER2s of metastatic ALNs were correlated with HER2 status and other clinicopathologic variables of the primary breast cancers. Among the 167 ALNs, 138 were metastatic and 29 were benign. The mean FNA-HER2 (6.3 ng/ml) of metastatic ALNs was higher than that of benign ALNs. All 29 benign ALNs showed no measurable value of FNA-HER2 (0.0 ng/ml). The area under the ROC curves of FNA-HER2 of ALNs was 0.679 for the diagnosis of ALN metastasis. The FNA-HER2 statuses of 108 metastatic ALNs (79.4%) were concordant with the HER2 statuses of the corresponding primary breast cancers. In a subgroup analysis of HER2-positive cancers with ALN metastasis, distant metastasis was significantly associated with FNA-HER2-negativity of metastatic ALNs (P = 0.04). Although FNA-HER2 of ALNs did not improve the diagnostic performance of FNA cytology in preoperative diagnosis of ALN metastasis of overall patients, FNA-HER2-positive metastatic ALNs were significantly associated with HER2-positivity of primary breast cancers. Additionally, FNA-HER2 analysis of ALN may help to develop more personalized treatment protocol for breast cancer patients by determining the concordance or discordance of HER2 status between primary cancers and metastatic ALNs.
Files in This Item:
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DOI
10.1371/journal.pone.0113065
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Kim, Hyun Ok(김현옥) ORCID logo https://orcid.org/0000-0002-4964-1963
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Suh, Young Joo(서영주) ORCID logo https://orcid.org/0000-0002-2078-5832
Yoon, Jung Hyun(윤정현) ORCID logo https://orcid.org/0000-0002-2100-3513
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100383
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