Comparação dos resultados de marcadores prognósticos e preditivos (HER2 e receptores de estrógeno e progesterona) para carcinoma de mama entre laboratórios locais e de referência no Brasil / Comparison of results of prognostic and predictive markers (HER2 and estrogen and progesterone receptors) for breast carcinoma between local and reference laboratories in Brazil

AUTOR(ES)
DATA DE PUBLICAÇÃO

2010

RESUMO

Breast cancer accounts for approximately one quarter of all cancers in females. The incidence of breast cancer in Brazil is about 50,000 new cases per year, and it is considered an important public health problem. HER2 and hormone receptors (estrogen and progesterone receptors) are considered the main prognostic and predictive markers for breast carcinoma. HER2 gene amplification or HER2 protein overexpression, detected in about 20 percent of breast carcinomas, predicts a more aggressive clinical course and determines eligibility for targeted therapy with trastuzumab. Hormonal therapy reduces the relative risk of recurrence by more than 50% in breast cancer patients with hormone-sensitive tumors. HER2 and hormone receptors testing has become an essential part of the clinical evaluation of all breast carcinoma patients, and accurate results are critical in identifying patients who may benefit from targeted therapy. The present study investigated the concordance in the results of HER2 and hormone receptors immunohistochemistry assays performed in 500 invasive breast carcinomas between a reference laboratory and local laboratories from all geographic regions of Brazil. Our results showed an overall poor concordance (171/500 cases, 34.2 percent) regarding HER2 results between local and reference laboratories, which may be related to the low-volume load of HER2 assays, inexperience with HER2 scoring system, and/or technical issues related to immunohistochemistry in local laboratories. The concordance of estrogen and progesterone receptors results was 89.4 percent (447/500 cases) and 85.0 percent (425/500 cases), respectively, between local and reference laboratories. Standardization of HER2 and hormone receptors testing with rigorous quality control measures by local laboratories is highly recommended in order to avoid erroneous treatment of breast cancer patients

ASSUNTO(S)

brasil brazil breast carcinoma carcinoma erbb-2 genes estrogen receptors genes erbb-2 immunohistochemistry imunoistoquímica laboratories laboratórios mama progesterone receptors receptores de progesterona receptores estrogênicos

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