Core needle biopsy in invasive breast cancer prognostic/predictive power: concordance with surgical speciemen and impact of immunophenotypes

Core needle biopsy (CNB) is currently considered the method of choice for tissue sampling to evaluate histopathological and biological features of breast lesions (1). The immunohistochemical (IHC) characterization of biomarkers status preceding surgical treatment is crucial when primary systemic therapy (neoadjuvant) or intraoperatory radiotherapy (IORT) are a therapeutic option. Surrogate definition of genetically- and molecularly-defined intrinsic breast cancer (BC) sub-types are typically based on the IHC staining for estrogen receptor (ER), progesterone receptor (PgR) and human epidermal growth receptor factor 2 (HER2). The classification group tumours includes Luminal, HER2- enriched and Triple Negative (2). The IHC assessment of Ki-67 antigen is used to evaluate the proliferative activity of BC. Ki-67 “high” expression is related to high risk of relapse and worse survival, but there is no standardized Ki-67 pathological interpretation and Ki-67 high expression cut-off value. The aim of the study is to assess the concordance between CNB and paired surgical resection specimen (SS) in evaluating biomarkers and molecular subtypes of early BC.