Comparison of tumor-infiltrating lymphocytes of breast cancer in core needle biopsies and resected specimens

a retrospective analysis

Yoon Jin Cha, Sung Gwe Ahn, Soong June Bae, Chang Ik Yoon, Jayeong Seo, Woo Hee Jung, Eun Ju Son, Jeong Joon

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose: Neoadjuvant chemotherapy (NAC) is being increasingly used to treat locally advanced breast cancer and to conserve the breast. In triple-negative breast cancer and HER2-positive breast cancer, a high density of tumor-infiltrating lymphocytes (TILs) is an important predictor of NAC response. Thus far, it remains unclear whether the TIL scores in core needle biopsies (CNBs) are closely representative of those in the whole tumor section in resected specimens. This study aimed to evaluate the concordance between the TIL scores of CNBs and resected specimens of breast cancer. Methods: A total of 220 matched pairs of CNBs and resected specimens of breast cancer were included. Stromal TILs were scored on slides stained with hematoxylin and eosin. Clinicopathologic parameters and the agreement of the TIL scores between CNBs and resected specimens were statistically analyzed. Results: The average TIL score was approximately 4.4% higher for the resected specimens than for the CNBs. When the tumors were divided into two groups according to a 60% TIL score cut-off (low and intermediate TIL vs. high TIL), 8.2% showed discordance between the CNB and resected specimen. The overall intraclass correlation coefficient (ICC) value of the TIL score was 0.895 (95% confidence interval, 0.864–0.920, P < 0.001), and all molecular subtypes showed ICC values over 0.8 (P < 0.001). The ICC values were > 0.9 when ≥ 5 cores were included in the CNBs. Tumors with discordant TILs were characterized by histologic grade III, ER negativity, high proliferative index, and HER2 and triple-negative subtypes. A high proliferative index was an independent risk factor for TIL discordance. Conclusions: The TIL score in CNB specimens is a reliable value that reflects the TIL status of the entire tumor in resected specimens of breast cancer. More than five CNB cores may accurately predict the TIL score of the entire tumor.

Original languageEnglish
Pages (from-to)295-302
Number of pages8
JournalBreast Cancer Research and Treatment
Volume171
Issue number2
DOIs
Publication statusPublished - 2018 Sep 1

Fingerprint

Large-Core Needle Biopsy
Tumor-Infiltrating Lymphocytes
Breast Neoplasms
Neoplasms
Triple Negative Breast Neoplasms
Drug Therapy
Hematoxylin
Eosine Yellowish-(YS)

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Cha, Yoon Jin ; Ahn, Sung Gwe ; Bae, Soong June ; Yoon, Chang Ik ; Seo, Jayeong ; Jung, Woo Hee ; Son, Eun Ju ; Joon, Jeong. / Comparison of tumor-infiltrating lymphocytes of breast cancer in core needle biopsies and resected specimens : a retrospective analysis. In: Breast Cancer Research and Treatment. 2018 ; Vol. 171, No. 2. pp. 295-302.
@article{0e327067db1841a6ac76f2883c427001,
title = "Comparison of tumor-infiltrating lymphocytes of breast cancer in core needle biopsies and resected specimens: a retrospective analysis",
abstract = "Purpose: Neoadjuvant chemotherapy (NAC) is being increasingly used to treat locally advanced breast cancer and to conserve the breast. In triple-negative breast cancer and HER2-positive breast cancer, a high density of tumor-infiltrating lymphocytes (TILs) is an important predictor of NAC response. Thus far, it remains unclear whether the TIL scores in core needle biopsies (CNBs) are closely representative of those in the whole tumor section in resected specimens. This study aimed to evaluate the concordance between the TIL scores of CNBs and resected specimens of breast cancer. Methods: A total of 220 matched pairs of CNBs and resected specimens of breast cancer were included. Stromal TILs were scored on slides stained with hematoxylin and eosin. Clinicopathologic parameters and the agreement of the TIL scores between CNBs and resected specimens were statistically analyzed. Results: The average TIL score was approximately 4.4{\%} higher for the resected specimens than for the CNBs. When the tumors were divided into two groups according to a 60{\%} TIL score cut-off (low and intermediate TIL vs. high TIL), 8.2{\%} showed discordance between the CNB and resected specimen. The overall intraclass correlation coefficient (ICC) value of the TIL score was 0.895 (95{\%} confidence interval, 0.864–0.920, P < 0.001), and all molecular subtypes showed ICC values over 0.8 (P < 0.001). The ICC values were > 0.9 when ≥ 5 cores were included in the CNBs. Tumors with discordant TILs were characterized by histologic grade III, ER negativity, high proliferative index, and HER2 and triple-negative subtypes. A high proliferative index was an independent risk factor for TIL discordance. Conclusions: The TIL score in CNB specimens is a reliable value that reflects the TIL status of the entire tumor in resected specimens of breast cancer. More than five CNB cores may accurately predict the TIL score of the entire tumor.",
author = "Cha, {Yoon Jin} and Ahn, {Sung Gwe} and Bae, {Soong June} and Yoon, {Chang Ik} and Jayeong Seo and Jung, {Woo Hee} and Son, {Eun Ju} and Jeong Joon",
year = "2018",
month = "9",
day = "1",
doi = "10.1007/s10549-018-4842-7",
language = "English",
volume = "171",
pages = "295--302",
journal = "Breast Cancer Research and Treatment",
issn = "0167-6806",
publisher = "Springer New York",
number = "2",

}

Comparison of tumor-infiltrating lymphocytes of breast cancer in core needle biopsies and resected specimens : a retrospective analysis. / Cha, Yoon Jin; Ahn, Sung Gwe; Bae, Soong June; Yoon, Chang Ik; Seo, Jayeong; Jung, Woo Hee; Son, Eun Ju; Joon, Jeong.

In: Breast Cancer Research and Treatment, Vol. 171, No. 2, 01.09.2018, p. 295-302.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Comparison of tumor-infiltrating lymphocytes of breast cancer in core needle biopsies and resected specimens

T2 - a retrospective analysis

AU - Cha, Yoon Jin

AU - Ahn, Sung Gwe

AU - Bae, Soong June

AU - Yoon, Chang Ik

AU - Seo, Jayeong

AU - Jung, Woo Hee

AU - Son, Eun Ju

AU - Joon, Jeong

PY - 2018/9/1

Y1 - 2018/9/1

N2 - Purpose: Neoadjuvant chemotherapy (NAC) is being increasingly used to treat locally advanced breast cancer and to conserve the breast. In triple-negative breast cancer and HER2-positive breast cancer, a high density of tumor-infiltrating lymphocytes (TILs) is an important predictor of NAC response. Thus far, it remains unclear whether the TIL scores in core needle biopsies (CNBs) are closely representative of those in the whole tumor section in resected specimens. This study aimed to evaluate the concordance between the TIL scores of CNBs and resected specimens of breast cancer. Methods: A total of 220 matched pairs of CNBs and resected specimens of breast cancer were included. Stromal TILs were scored on slides stained with hematoxylin and eosin. Clinicopathologic parameters and the agreement of the TIL scores between CNBs and resected specimens were statistically analyzed. Results: The average TIL score was approximately 4.4% higher for the resected specimens than for the CNBs. When the tumors were divided into two groups according to a 60% TIL score cut-off (low and intermediate TIL vs. high TIL), 8.2% showed discordance between the CNB and resected specimen. The overall intraclass correlation coefficient (ICC) value of the TIL score was 0.895 (95% confidence interval, 0.864–0.920, P < 0.001), and all molecular subtypes showed ICC values over 0.8 (P < 0.001). The ICC values were > 0.9 when ≥ 5 cores were included in the CNBs. Tumors with discordant TILs were characterized by histologic grade III, ER negativity, high proliferative index, and HER2 and triple-negative subtypes. A high proliferative index was an independent risk factor for TIL discordance. Conclusions: The TIL score in CNB specimens is a reliable value that reflects the TIL status of the entire tumor in resected specimens of breast cancer. More than five CNB cores may accurately predict the TIL score of the entire tumor.

AB - Purpose: Neoadjuvant chemotherapy (NAC) is being increasingly used to treat locally advanced breast cancer and to conserve the breast. In triple-negative breast cancer and HER2-positive breast cancer, a high density of tumor-infiltrating lymphocytes (TILs) is an important predictor of NAC response. Thus far, it remains unclear whether the TIL scores in core needle biopsies (CNBs) are closely representative of those in the whole tumor section in resected specimens. This study aimed to evaluate the concordance between the TIL scores of CNBs and resected specimens of breast cancer. Methods: A total of 220 matched pairs of CNBs and resected specimens of breast cancer were included. Stromal TILs were scored on slides stained with hematoxylin and eosin. Clinicopathologic parameters and the agreement of the TIL scores between CNBs and resected specimens were statistically analyzed. Results: The average TIL score was approximately 4.4% higher for the resected specimens than for the CNBs. When the tumors were divided into two groups according to a 60% TIL score cut-off (low and intermediate TIL vs. high TIL), 8.2% showed discordance between the CNB and resected specimen. The overall intraclass correlation coefficient (ICC) value of the TIL score was 0.895 (95% confidence interval, 0.864–0.920, P < 0.001), and all molecular subtypes showed ICC values over 0.8 (P < 0.001). The ICC values were > 0.9 when ≥ 5 cores were included in the CNBs. Tumors with discordant TILs were characterized by histologic grade III, ER negativity, high proliferative index, and HER2 and triple-negative subtypes. A high proliferative index was an independent risk factor for TIL discordance. Conclusions: The TIL score in CNB specimens is a reliable value that reflects the TIL status of the entire tumor in resected specimens of breast cancer. More than five CNB cores may accurately predict the TIL score of the entire tumor.

UR - http://www.scopus.com/inward/record.url?scp=85048030555&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85048030555&partnerID=8YFLogxK

U2 - 10.1007/s10549-018-4842-7

DO - 10.1007/s10549-018-4842-7

M3 - Article

VL - 171

SP - 295

EP - 302

JO - Breast Cancer Research and Treatment

JF - Breast Cancer Research and Treatment

SN - 0167-6806

IS - 2

ER -