Biopsy confirmation of metastatic sites in breast cancer patients

clinical impact and future perspectives

Carmen Criscitiello, Fabrice André, Alastair M. Thompson, Michele De Laurentiis, Angela Esposito, Lucia Gelao, Luca Fumagalli, Marzia Locatelli, Ida Minchella, Franco Orsi, Aron Goldhirsch, Guiseppe Curigliano (Lead / Corresponding author)

    Research output: Contribution to journalArticle

    31 Citations (Scopus)
    71 Downloads (Pure)

    Abstract

    Determination of hormone receptor (estrogen receptor and progesterone receptor) and human epidermal growth factor receptor 2 status in the primary tumor is clinically relevant to define breast cancer subtypes, clinical outcome, and the choice of therapy. Retrospective and prospective studies suggest that there is substantial discordance in receptor status between primary and recurrent breast cancer. Despite this evidence and current recommendations, the acquisition of tissue from metastatic deposits is not routine practice. As a consequence, therapeutic decisions for treatment in the metastatic setting are based on the features of the primary tumor. Reasons for this attitude include the invasiveness of the procedure and the unreliable outcome of biopsy, in particular for biopsies of lesions at complex visceral sites. Improvements in interventional radiology techniques mean that most metastatic sites are now accessible by minimally invasive methods, including surgery. In our opinion, since biopsies are diagnostic and changes in biological features between the primary and secondary tumors can occur, the routine biopsy of metastatic disease needs to be performed. In this review, we discuss the rationale for biopsy of suspected breast cancer metastases, review issues and caveats surrounding discordance of biomarker status between primary and metastatic tumors, and provide insights for deciding when to perform biopsy of suspected metastases and which one (s) to biopsy. We also speculate on the future translational implications for biopsy of suspected metastatic lesions in the context of clinical trials and the establishment of bio-banks of biopsy material taken from metastatic sites. We believe that such bio-banks will be important for exploring mechanisms of metastasis. In the future, advances in targeted therapy will depend on the availability of metastatic tissue.
    Original languageEnglish
    Article number205
    Number of pages10
    JournalBreast Cancer Research
    Volume16
    Issue number2
    DOIs
    Publication statusPublished - 21 Mar 2014

    Fingerprint

    Breast Neoplasms
    Biopsy
    Neoplasm Metastasis
    Neoplasms
    Interventional Radiology
    Progesterone Receptors
    Therapeutics
    Estrogen Receptors
    Retrospective Studies
    Biomarkers
    Clinical Trials
    Hormones
    Prospective Studies

    Cite this

    Criscitiello, C., André, F., Thompson, A. M., De Laurentiis, M., Esposito, A., Gelao, L., ... Curigliano, G. (2014). Biopsy confirmation of metastatic sites in breast cancer patients: clinical impact and future perspectives. Breast Cancer Research, 16(2), [205]. https://doi.org/10.1186/bcr3630
    Criscitiello, Carmen ; André, Fabrice ; Thompson, Alastair M. ; De Laurentiis, Michele ; Esposito, Angela ; Gelao, Lucia ; Fumagalli, Luca ; Locatelli, Marzia ; Minchella, Ida ; Orsi, Franco ; Goldhirsch, Aron ; Curigliano, Guiseppe. / Biopsy confirmation of metastatic sites in breast cancer patients : clinical impact and future perspectives. In: Breast Cancer Research. 2014 ; Vol. 16, No. 2.
    @article{5db5c69ce2884dde89a99983e7a99ab8,
    title = "Biopsy confirmation of metastatic sites in breast cancer patients: clinical impact and future perspectives",
    abstract = "Determination of hormone receptor (estrogen receptor and progesterone receptor) and human epidermal growth factor receptor 2 status in the primary tumor is clinically relevant to define breast cancer subtypes, clinical outcome, and the choice of therapy. Retrospective and prospective studies suggest that there is substantial discordance in receptor status between primary and recurrent breast cancer. Despite this evidence and current recommendations, the acquisition of tissue from metastatic deposits is not routine practice. As a consequence, therapeutic decisions for treatment in the metastatic setting are based on the features of the primary tumor. Reasons for this attitude include the invasiveness of the procedure and the unreliable outcome of biopsy, in particular for biopsies of lesions at complex visceral sites. Improvements in interventional radiology techniques mean that most metastatic sites are now accessible by minimally invasive methods, including surgery. In our opinion, since biopsies are diagnostic and changes in biological features between the primary and secondary tumors can occur, the routine biopsy of metastatic disease needs to be performed. In this review, we discuss the rationale for biopsy of suspected breast cancer metastases, review issues and caveats surrounding discordance of biomarker status between primary and metastatic tumors, and provide insights for deciding when to perform biopsy of suspected metastases and which one (s) to biopsy. We also speculate on the future translational implications for biopsy of suspected metastatic lesions in the context of clinical trials and the establishment of bio-banks of biopsy material taken from metastatic sites. We believe that such bio-banks will be important for exploring mechanisms of metastasis. In the future, advances in targeted therapy will depend on the availability of metastatic tissue.",
    author = "Carmen Criscitiello and Fabrice Andr{\'e} and Thompson, {Alastair M.} and {De Laurentiis}, Michele and Angela Esposito and Lucia Gelao and Luca Fumagalli and Marzia Locatelli and Ida Minchella and Franco Orsi and Aron Goldhirsch and Guiseppe Curigliano",
    year = "2014",
    month = "3",
    day = "21",
    doi = "10.1186/bcr3630",
    language = "English",
    volume = "16",
    journal = "Breast Cancer Research",
    issn = "1465-5411",
    publisher = "Springer Verlag",
    number = "2",

    }

    Criscitiello, C, André, F, Thompson, AM, De Laurentiis, M, Esposito, A, Gelao, L, Fumagalli, L, Locatelli, M, Minchella, I, Orsi, F, Goldhirsch, A & Curigliano, G 2014, 'Biopsy confirmation of metastatic sites in breast cancer patients: clinical impact and future perspectives', Breast Cancer Research, vol. 16, no. 2, 205. https://doi.org/10.1186/bcr3630

    Biopsy confirmation of metastatic sites in breast cancer patients : clinical impact and future perspectives. / Criscitiello, Carmen; André, Fabrice; Thompson, Alastair M.; De Laurentiis, Michele; Esposito, Angela; Gelao, Lucia; Fumagalli, Luca; Locatelli, Marzia; Minchella, Ida; Orsi, Franco; Goldhirsch, Aron; Curigliano, Guiseppe (Lead / Corresponding author).

    In: Breast Cancer Research, Vol. 16, No. 2, 205, 21.03.2014.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Biopsy confirmation of metastatic sites in breast cancer patients

    T2 - clinical impact and future perspectives

    AU - Criscitiello, Carmen

    AU - André, Fabrice

    AU - Thompson, Alastair M.

    AU - De Laurentiis, Michele

    AU - Esposito, Angela

    AU - Gelao, Lucia

    AU - Fumagalli, Luca

    AU - Locatelli, Marzia

    AU - Minchella, Ida

    AU - Orsi, Franco

    AU - Goldhirsch, Aron

    AU - Curigliano, Guiseppe

    PY - 2014/3/21

    Y1 - 2014/3/21

    N2 - Determination of hormone receptor (estrogen receptor and progesterone receptor) and human epidermal growth factor receptor 2 status in the primary tumor is clinically relevant to define breast cancer subtypes, clinical outcome, and the choice of therapy. Retrospective and prospective studies suggest that there is substantial discordance in receptor status between primary and recurrent breast cancer. Despite this evidence and current recommendations, the acquisition of tissue from metastatic deposits is not routine practice. As a consequence, therapeutic decisions for treatment in the metastatic setting are based on the features of the primary tumor. Reasons for this attitude include the invasiveness of the procedure and the unreliable outcome of biopsy, in particular for biopsies of lesions at complex visceral sites. Improvements in interventional radiology techniques mean that most metastatic sites are now accessible by minimally invasive methods, including surgery. In our opinion, since biopsies are diagnostic and changes in biological features between the primary and secondary tumors can occur, the routine biopsy of metastatic disease needs to be performed. In this review, we discuss the rationale for biopsy of suspected breast cancer metastases, review issues and caveats surrounding discordance of biomarker status between primary and metastatic tumors, and provide insights for deciding when to perform biopsy of suspected metastases and which one (s) to biopsy. We also speculate on the future translational implications for biopsy of suspected metastatic lesions in the context of clinical trials and the establishment of bio-banks of biopsy material taken from metastatic sites. We believe that such bio-banks will be important for exploring mechanisms of metastasis. In the future, advances in targeted therapy will depend on the availability of metastatic tissue.

    AB - Determination of hormone receptor (estrogen receptor and progesterone receptor) and human epidermal growth factor receptor 2 status in the primary tumor is clinically relevant to define breast cancer subtypes, clinical outcome, and the choice of therapy. Retrospective and prospective studies suggest that there is substantial discordance in receptor status between primary and recurrent breast cancer. Despite this evidence and current recommendations, the acquisition of tissue from metastatic deposits is not routine practice. As a consequence, therapeutic decisions for treatment in the metastatic setting are based on the features of the primary tumor. Reasons for this attitude include the invasiveness of the procedure and the unreliable outcome of biopsy, in particular for biopsies of lesions at complex visceral sites. Improvements in interventional radiology techniques mean that most metastatic sites are now accessible by minimally invasive methods, including surgery. In our opinion, since biopsies are diagnostic and changes in biological features between the primary and secondary tumors can occur, the routine biopsy of metastatic disease needs to be performed. In this review, we discuss the rationale for biopsy of suspected breast cancer metastases, review issues and caveats surrounding discordance of biomarker status between primary and metastatic tumors, and provide insights for deciding when to perform biopsy of suspected metastases and which one (s) to biopsy. We also speculate on the future translational implications for biopsy of suspected metastatic lesions in the context of clinical trials and the establishment of bio-banks of biopsy material taken from metastatic sites. We believe that such bio-banks will be important for exploring mechanisms of metastasis. In the future, advances in targeted therapy will depend on the availability of metastatic tissue.

    UR - http://www.scopus.com/inward/record.url?scp=84899062146&partnerID=8YFLogxK

    U2 - 10.1186/bcr3630

    DO - 10.1186/bcr3630

    M3 - Article

    VL - 16

    JO - Breast Cancer Research

    JF - Breast Cancer Research

    SN - 1465-5411

    IS - 2

    M1 - 205

    ER -

    Criscitiello C, André F, Thompson AM, De Laurentiis M, Esposito A, Gelao L et al. Biopsy confirmation of metastatic sites in breast cancer patients: clinical impact and future perspectives. Breast Cancer Research. 2014 Mar 21;16(2). 205. https://doi.org/10.1186/bcr3630