Journal
HUMAN PATHOLOGY
Volume 41, Issue 6, Pages 914-917Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.humpath.2009.10.022
Keywords
Breast; Metastasis; HER-2; Autopsy
Categories
Funding
- DOD Center of Excellence [W81XWH-04-1-0595]
- NIH [P50 CA88843]
- NATIONAL CANCER INSTITUTE [P50CA088843] Funding Source: NIH RePORTER
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We report a case of a patient with invasive breast carcinoma that demonstrated HER-2 gene amplification on core biopsy, who relapsed while on adjuvant trastuzumab therapy after her mastectomy and ultimately died 15 months after diagnosis. Surprisingly, analysis of multiple metastases harvested at rapid autopsy demonstrated no evidence of HER-2 gene amplification. Retrospective examination of the carcinoma in the patient's mastectomy specimen revealed only focal HER-2 amplification within the tumor, localized to the region of the prior core biopsy site. This case highlights several important issues in HER-2 testing of breast cancer, including core biopsy-excision specimen discordance, primary-metastasis discordance, and potential selection for unamplified portions of a heterogeneously amplified tumors by trastuzumab. (C) 2010 Elsevier Inc. All rights reserved.
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