Discordance in ERα, PR and HER2 receptor status across different distant breast cancer metastases within the same patient

L. D.C. Hoefnagel, P. Van Der Groep, M. J. Van De Vijver, J. E. Boers, P. Wesseling, J. Wesseling, E. Van Der Wall, P. J. Van Diest

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Background: We studied discordance in estrogen receptor alpha (ERα), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) status between multiple distant metastases from the same breast cancer patient. Material and methods: Multiple distant metastases from 55 female patients were stained for ERα, PR and HER2 by immunohistochemistry and in situ hybridization for confirmation of the HER2 status. Results: Different metastatic sites within the same patient showed discordance in ERa receptor status in 7.3% or 10.9% of patients (using a 10% or 1% threshold for positivity, respectively). For PR, 29.1% or 30.9% of patients showed discordance. Taking ERa and PR together, 36.4% of cases (both thresholds) showed discrepancy between metastases. In 10.9% (10% threshold) or 14.5% of patients (1% threshold), such discordance could have clinical consequences with regard to hormonal treatment. For HER2, there was 3.6% discordance on the immunohistochemical level but 0% on the gene level. Conclusion: In a significant proportion of metastatic breast cancer patients, discordance in ERα and PR receptor status between different metastatic sites was observed. This implies that multiple metastases may need to be biopsied to optimally reassess receptors.

Original languageEnglish (US)
Pages (from-to)3017-3023
Number of pages7
JournalAnnals of Oncology
Issue number12
StatePublished - Dec 2013
Externally publishedYes


  • Breast cancer
  • ERα
  • HER2
  • Immunohistochemistry
  • Multiple metastases
  • PR

ASJC Scopus subject areas

  • Hematology
  • Oncology


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