The rate of Estrogen receptors ,progesterone receptors and pidermal growth factor 2 receptors discordance between primary and recurrent breast cancer and its effect on survival

Background:Treatment of recurrent breast cancer, like treatment of early-stage breast cancer, is based on consideration of tumor biology and clinical history. Thus, characterization of tumor hormonal and HER2 status is critical for all patients, and a detailed assessment of past treatment, including timing of therapies as well as patient symptoms and functional assessment, is essential. Determination of hormone receptor status and HER2 status should be repeated in all cases of first recurrence when diagnostic tissue is obtained because there may be discordance between the primary and recurrent tumors. Aim of study: 1-To determine the rate of discordance of estrogen ,progestron and epidermal growth factor2 (HER2) receptors between primary and recurrent breast cancer. 2-To study the effect of the discordance on patient's disease free survival Patients and method: The study was conducted retrospectively and included 100 Iraqi female patients attended Baghdad oncology teaching hospital between January 2012 and December 2017 for whom estrogen receptors , progesteron receptors status were known at time of diagnosis and had been obtained on new tissue biopsy at time of recurrence. Results: 1-The rate of discordance for estrogen receptors ,progestron receptors and HER2 receptors between primary and recurrent tumor are 24%,27%,17% respectively 2-There was not statistically significant difference in the disease free survival between concordant and discordant cases for both estrogen receptors and progestron receptors while there is a significant difference in form of increase disease free survival of the epidermal growth factor 2 receptors discordant cases compared to concordant ones. Conclusion:The effect hormonal receptors discordance on disease free survival not statistically significant ,while the gain of HER2 receptors after recurrence is associated with better survival.