Biopsy needed with recurrent breast cancer

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CypressCynthia
CypressCynthia Member Posts: 4,014 Member
edited January 2012 in Breast Cancer #1
I was "fortunate" in that, because it had been so long since my breast cancer, we did a biopsy to both confirm diagnosis and to see what we were dealing with. My original tumor was ER and PR positive. My metastasis was ER + but PR negative. It is fairly common for breast cancer to change over time.

Studies are beginning to show that we need a biopsy with recurrence, not only to obtain diagnosis, but to find out if the tumor has changed so that it can be appropriately treated. At MDA, I was told that it is not uncommon for the original tumor to change and, for example, an ER + to morph into an ER negative.

See synopsis from a recent study below:

"Results: Two hundred and eighty-nine patients underwent biopsy. Recurrent biopsy specimens were obtained from locoregional recurrence in 48.1% and from distant metastases in 51.9%. Distant sites included skin/soft tissue (25.0%), bone/bone marrow (19.2%) and liver (15.8%). Benign disease or second primary cancer was observed in 7.6% of biopsies. Discordance in ER, PgR or HER2 between confirmed primary and recurrent breast cancer was 12.6%, 31.2% and 5.5%, respectively (all p < 0.001). Biopsy results altered management in 14.2% of patients undergoing biopsy (95% confidence intervals 10.4–18.8%, p ≤ 0.0001). The duration between primary and recurrent disease, the site of recurrence and the receptor profile of the primary tumour did not affect discordance rates.

Conclusions: There is substantial discordance in receptor status between primary and recurrent breast cancer. The number needed to biopsy in order to alter treatment was 7.1. Patients with recurrent breast cancer should have tissue confirmation of receptor status of recurrent disease."

http://www.oncologystat.com/journals/journal_scans/Tissue_Confirmation_of_Disease_Recurrence_in_Breast_Cancer_Patients_Pooled_Analysis_of_Multi-Centre_Multi-Disciplinary_Prospective_Studies.html

Comments

  • SIROD
    SIROD Member Posts: 2,194 Member
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    Change?
    Hi,

    I thought it was standard protocol to have a biopsy after a recurrence especially if they are at least a year apart.

    My ER% changed over time, sometimes more, sometimes less. My PR% did in a way, I was PR- at diagnose, when to PR+ first recurrence and once again I am back to negative as the number was so small, they wouldn't count it. My oncologist would not discuss anything until I had one.

    It can still change can't it, even during treatment?

    Best,

    Doris
  • natly15
    natly15 Member Posts: 1,941
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    CC again thank you so much
    CC again thank you so much for this info. It is something I didnt know. I so appreciate you and all the help you provide.
  • LoveBabyJesus
    LoveBabyJesus Member Posts: 1,679 Member
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    :)
    Thank you for always sharing great articles and information with us. They are always helpful.
  • Double Whammy
    Double Whammy Member Posts: 2,832 Member
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    :)
    Thank you for always sharing great articles and information with us. They are always helpful.

    Such helpful information
    Having had 2 primary cancers and knowing that they both like to go to some of the same places, I asked early on if I had a recurrence, how would we know which one it was. I was told it would have to be biopsied. Sometime during my treatment, I decided to worry about things like what if I had mets somewhere and "they" said X cancer seldom goes there so it must be Y cancer and whether I'd be satisfied with that conclusion. Since I'm not planning on a recurrence of either, I won't have to worry about that, but I'll remember it for someone else . . .

    Thank you, Eileen.

    Suzanne
  • Double Whammy
    Double Whammy Member Posts: 2,832 Member
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    Such helpful information
    Having had 2 primary cancers and knowing that they both like to go to some of the same places, I asked early on if I had a recurrence, how would we know which one it was. I was told it would have to be biopsied. Sometime during my treatment, I decided to worry about things like what if I had mets somewhere and "they" said X cancer seldom goes there so it must be Y cancer and whether I'd be satisfied with that conclusion. Since I'm not planning on a recurrence of either, I won't have to worry about that, but I'll remember it for someone else . . .

    Thank you, Eileen.

    Suzanne

    Oops