PMID- 29052527
OWN - NLM
STAT- MEDLINE
DCOM- 20180705
LR  - 20181113
IS  - 1477-7819 (Electronic)
IS  - 1477-7819 (Linking)
VI  - 15
IP  - 1
DP  - 2017 Oct 19
TI  - Negative genic switch of HER-2 in the primary tumor instead of the synchronous 
      metastatic nodal lesions after neoadjuvant chemotherapy in a patient with primary 
      HER2-positive breast cancer.
PG  - 189
LID - 10.1186/s12957-017-1255-8 [doi]
LID - 189
AB  - BACKGROUND: A few retrospective studies have indicated that neoadjuvant 
      chemotherapy (NAC) in breast cancer may change biomarker profiles of the primary 
      tumor. Little is known about the status of HER-2 gene of the synchronous nodal 
      metastases when that of the residual tumor undergoes negative conversion in a 
      neoadjuvant setting. CASE PRESENTATION: We describe a female patient with left 
      breast cancer (T2N2M0) who underwent negative conversion of HER-2 in the primary 
      tumor instead of the synchronous nodal lesions after NAC. Core needle biopsy 
      showed invasive ductal carcinoma with HER2 immunohistochemistry (IHC) (2+) and 
      amplified HER-2 gene determined by fluorescence in situ hybridization (FISH). 
      Then, the patient underwent 4 cycles of anthracycline- and taxane-based NAC and 
      subsequent left modified radical mastectomy. Postoperative pathology showed 
      invasive ductal carcinoma involving 4 of 12 surgically excised axillary lymph 
      nodes with HER2 IHC (1+) and FISH negative (HER2 gene not amplified) in the 
      residual tumor of the breast specimen. Due to the negative genic switch of HER2 
      after NAC, the patient rejected to accept trastuzumab. Under the patient's 
      consent, the synchronous nodal lesions were further investigated and showed HER2 
      IHC(-) but FISH positive (HER-2 gene amplified). Therefore, the patient agreed to 
      accept adjuvant trastuzumab treatment every 3 weeks for 1 year. CONCLUSIONS: We 
      propose further assessment of HER2 gene in the synchronous nodal metastases, 
      especially when negative genic switch of HER-2 occurs in the primary tumor after 
      NAC in order to tailor the systemic regimens for breast cancer patients.
FAU - Chen, Hao-Ran
AU  - Chen HR
AD  - Department of Endocrine & Breast Surgery, The First Affiliated Hospital of 
      Chongqing Medical University, No.1, Youyi Road, Yuanjiagang, Yuzhong District, 
      Chongqing, 400016, China.
FAU - Wu, Yu-Tuan
AU  - Wu YT
AD  - Department of Endocrine & Breast Surgery, The First Affiliated Hospital of 
      Chongqing Medical University, No.1, Youyi Road, Yuanjiagang, Yuzhong District, 
      Chongqing, 400016, China.
FAU - Yu, Qiu-Bo
AU  - Yu QB
AD  - Center for Molecular Medicine Testing, Chongqing Medical University, No.1, 
      Yixueyuan Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China.
FAU - Yang, Ya-Ying
AU  - Yang YY
AD  - Clinical Diagnostic Pathology Center, Chongqing Medical University, No.1, 
      Yixueyuan Road, Yuanjiagang, Yuzhong District, Chongqing, 400016, China.
FAU - Wei, Yu-Xian
AU  - Wei YX
AD  - Department of Endocrine & Breast Surgery, The First Affiliated Hospital of 
      Chongqing Medical University, No.1, Youyi Road, Yuanjiagang, Yuzhong District, 
      Chongqing, 400016, China.
FAU - Li, Hong-Yuan
AU  - Li HY
AD  - Department of Endocrine & Breast Surgery, The First Affiliated Hospital of 
      Chongqing Medical University, No.1, Youyi Road, Yuanjiagang, Yuzhong District, 
      Chongqing, 400016, China.
FAU - Wu, Kai-Nan
AU  - Wu KN
AD  - Department of Endocrine & Breast Surgery, The First Affiliated Hospital of 
      Chongqing Medical University, No.1, Youyi Road, Yuanjiagang, Yuzhong District, 
      Chongqing, 400016, China.
FAU - Kong, Ling-Quan
AU  - Kong LQ
AD  - Department of Endocrine & Breast Surgery, The First Affiliated Hospital of 
      Chongqing Medical University, No.1, Youyi Road, Yuanjiagang, Yuzhong District, 
      Chongqing, 400016, China. huihuikp@163.com.
LA  - eng
PT  - Journal Article
DEP - 20171019
PL  - England
TA  - World J Surg Oncol
JT  - World journal of surgical oncology
JID - 101170544
RN  - 0 (Antineoplastic Agents, Immunological)
RN  - EC 2.7.10.1 (ERBB2 protein, human)
RN  - EC 2.7.10.1 (Receptor, ErbB-2)
RN  - P188ANX8CK (Trastuzumab)
SB  - IM
MH  - Antineoplastic Agents, Immunological/therapeutic use
MH  - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use
MH  - Axilla
MH  - Biopsy, Large-Core Needle
MH  - Breast Neoplasms/*genetics/pathology/therapy
MH  - Carcinoma, Ductal, Breast/*genetics/pathology/secondary/therapy
MH  - Chemoradiotherapy, Adjuvant
MH  - Female
MH  - Humans
MH  - Immunohistochemistry
MH  - In Situ Hybridization, Fluorescence
MH  - Lymph Nodes/*pathology/surgery
MH  - Lymphatic Metastasis
MH  - Mastectomy
MH  - Middle Aged
MH  - Neoadjuvant Therapy/*methods
MH  - Receptor, ErbB-2/antagonists & inhibitors/*genetics
MH  - Trastuzumab/therapeutic use
PMC - PMC5649047
OTO - NOTNLM
OT  - Axillary lymph node metastases
OT  - Breast cancer
OT  - Genic switch of HER2
OT  - Neoadjuvant chemotherapy
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The analysis was performed in 
      accordance with the ethical standards of the First Affiliated Hospital of 
      Chongqing Medical University. CONSENT FOR PUBLICATION: Not applicable COMPETING 
      INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S 
      NOTE: Springer Nature remains neutral with regard to jurisdictional claims in 
      published maps and institutional affiliations.
EDAT- 2017/10/21 06:00
MHDA- 2018/07/06 06:00
PMCR- 2017/10/19
CRDT- 2017/10/21 06:00
PHST- 2017/02/01 00:00 [received]
PHST- 2017/10/09 00:00 [accepted]
PHST- 2017/10/21 06:00 [entrez]
PHST- 2017/10/21 06:00 [pubmed]
PHST- 2018/07/06 06:00 [medline]
PHST- 2017/10/19 00:00 [pmc-release]
AID - 10.1186/s12957-017-1255-8 [pii]
AID - 1255 [pii]
AID - 10.1186/s12957-017-1255-8 [doi]
PST - epublish
SO  - World J Surg Oncol. 2017 Oct 19;15(1):189. doi: 10.1186/s12957-017-1255-8.