27P - A meta-analysis of oestrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 discordance between primary breast cancer...

Date 08 May 2014
Event IMPAKT 2014
Session Welcome reception and Poster Walk
Topics Biomarkers
Breast Cancer
Pathology/Molecular Biology
Presenter Gaetano Aurilio
Citation Annals of Oncology (2014) 25 (suppl_1): i8-i16. 10.1093/annonc/mdu066
Authors G. Aurilio1, D. Disalvatore2, G. Pruneri3, V. Bagnardi4, G. Viale3, G. Curigliano1, A. Goldhirsch1, E. Munzone1, F. De Vita5, F. Nolè1
  • 1Oncologia Medica 1, Istituto Europeo di Oncologia, 20141 - Milano/IT
  • 2Division Of Epidemiology And Biostatistics, Istituto Europeo di Oncologia, 20141 - Milano/IT
  • 3Division Of Pathology, University Of Milan, School Of Medicine, Istituto Europeo di Oncologia, 20141 - Milano/IT
  • 4Division Of Epidemiology And Biostatistics, Department Of Statistics And Quantitative Methods, University Of Milan-bicocca, Istituto Europeo di Oncologia, 20141 - Milano/IT
  • 5Medical Oncology, Second University of Naples, Naples/IT



The discordance in estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth factor receptor 2 (HER2) status between primary and recurrent breast cancer is being intensively investigated and a large amount of data have been produced. However, results from different studies are heterogeneous and often conflicting. To highlight this issue, a meta-analysis of published data was performed.


A literature search was performed using Medline, and all the studies published from 1983 to 2011 comparing changes in ER, PgR and/or HER2 status in patients with matched breast primary and recurrent tumours were included. We used random-effects models to estimate pooled discordance proportions.


We selected 48 articles, mostly reporting retrospective studies. Thirty-three, 24 and 31 articles were focused on ER, PgR and HER2 changes, respectively. A total of 4200, 2739 and 2987 tumours were evaluated for ER, PgR and HER2 discordance, respectively. The heterogeneity between study-specific discordance proportions was high for ER (I(2) = 91%, p < 0.0001), PgR (I(2) = 79%, p < 0.0001) and HER2 (I(2) = 77%, p < 0.0001). Pooled discordance proportions were 20% (95% confidence interval (CI): 16-35%) for ER, 33% (95% CI: 29-38%) for PgR and 8% (95% CI: 6-10%) for HER2. Pooled proportions of tumours shifting from positive to negative and from negative to positive were 24% and 14% for ER (p = 0.0183), respectively. The same figures were 46% and 15% for PgR (p < 0.0001), and 13% and 5% for HER2 (p = 0.0004).


Our findings strengthen the concept that changes in receptor expression may occur during the natural history of breast cancer, suggesting clinical implications and a possible impact on treatment choice.


All authors have declared no conflicts of interest.