What does this research mean for the field?

Universal repeat testing of breast biomarkers (ER, PR, HER2) in excision specimens is unnecessary, but reflex re-testing is warranted for post-neoadjuvant therapy cases and tumors larger than 2 cm due to significantly higher discordance rates. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.SUPPORTS_CONSENSUS.

What question did this study set out to answer?

To evaluate whether universal repeat testing of estrogen receptors, progesterone receptors, and HER2 in surgical excision specimens is warranted compared to initial diagnostic biopsies.

September 3, 2026HCA Healthcare Journal of MedicineOpen Access

Comparing the Expression of Estrogen Receptors, Progesterone Receptors, and Human Epidermal Growth Factor Receptor 2 Between Initial Biopsy and Excision Specimens in Invasive Breast Carcinoma Cases. Is There a Need for Universal Repeat Testing? Experience From a Community Hospital

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Authors

ASAstrid M Sacasa GWGul Emek Wymer SFSusana FerráFlorida Cancer Care

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Implication

Cohort study reveals significant biomarker discordance in post-neoadjuvant and large breast tumors, indicating selective re-testing is preferable to universal screening.

Key Points

To evaluate whether universal repeat testing of estrogen receptors, progesterone receptors, and HER2 in surgical excision specimens is warranted compared to initial diagnostic biopsies.
Evaluated 70 sequential patients with invasive breast carcinoma who underwent biomarker testing on both initial core needle biopsies and subsequent surgical resection specimens.
Assessed discordance rates across clinicopathologic variables, including tumor size, presence of ductal carcinoma in situ, nodal stage, and neoadjuvant therapy exposure.
Overall biomarker discordance occurred in 10 of 70 patients (14%), with discordance significantly higher in the neoadjuvant therapy group (35.3%) than in non-neoadjuvant controls (7.5%, P = .0091).
Tumors larger than 2 cm demonstrated a significantly higher rate of biomarker discordance compared to smaller tumors (P = .0082).
Receptor conversions included 3 of 8 (37.5%) hormone receptor-positive tumors becoming negative, 2 of 4 (50%) HER2-positive tumors becoming negative, and 5 of 66 (7.6%) HER2-negative tumors becoming positive.

Cite This Study

Sacasa et al. (2026) studied this question.

synapsesocial.com/papers/6a9935f3636c6408cfa7ea06 https://doi.org/10.36518/2689-0216.2338

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Implication

Cohort study reveals significant biomarker discordance in post-neoadjuvant and large breast tumors, indicating selective re-testing is preferable to universal screening.

Comparing the Expression of Estrogen Receptors, Progesterone Receptors, and Human Epidermal Growth Factor Receptor 2 Between Initial Biopsy and Excision Specimens in Invasive Breast Carcinoma Cases. Is There a Need for Universal Repeat Testing? Experience From a Community Hospital

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Key Points

Cite This Study

Comparing the Expression of Estrogen Receptors, Progesterone Receptors, and Human Epidermal Growth Factor Receptor 2 Between Initial Biopsy and Excision Specimens in Invasive Breast Carcinoma Cases. Is There a Need for Universal Repeat Testing? Experience From a Community Hospital

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