Abstract: Objective: To investigate the discordance for estrogen receptor (ER), progestin receptor (PR) and human epidermal growth factor receptor 2 (Her-2) expressions in the primary lesion of breast cancer and ipsilateral axillary lymph node metastases, and to discuss the effect of discordance on the prognosis of patients.Methods: The climical materials and pathological samples of 120 cases of breast cancer patients with ipsilateral axillary lymph node metastasis were collected.The expressions of ER, PR, Her-2 and Ki-67 in the primary lesion and axillary lymph node metastasis of the breast cancer patients were detected by immunohistochemistry.Paired Chi-square test was used to analyze the differences in the receptor expressions between the primary lesion and the axillary lymph node metastasis.Chi-square test was used to evaluate the correlations between the Ki-67 expression and the receptor expressions and the correlations between the clinical characteristics of breast cancer and the expression differences in ER, PR and Her-2.Spearman correlation analysis was used to analyze the correlations between the clinical stages of breast cancer and the expression differences of ER, PR and Her-2.Survival analysis was conducted by Kaplan-Meier method.Results: There were some differences in the expression of levels of ER, PR and Her-2 between the primary lesion and the ipsilateral lymph node metastasis, but there was no statistically significant differences (P>0.05).The clinical stages of breast cancer were related to the expression differences of ER and PR (P<0.05).The Ki-67 expression was significantly associated with the expressions of ER and PR in primary lesion of breast cancer patients(P＜0.05).There were a statistically significant differences in the overall survival (OS) and disease-free survival (DFS) between concordant and discordant cases for ER status in the primary lesion and the corresponding lymph node metastasis (P<0.05).The OS and DFS were significantly lower in the discordant cases for ER status.The OS and DFS of the patients with ER-positive in the primary lesion and ER-positive in the lymph node metastasis were higher than those of the patients with ER positive in the primary lesion and ER negative in the lympy node metastasis (+/+ vs.+/-)(P< 0.05).The OS of the patients with ER-negative in the primary lesion and ER-negative in the lymph node metastasis than that of the patients with ER-negative in the primary lesion and ER-positive in the lymph node metastasis(-/+ vs. -/+)(P< 0.05);but the difference of DFS was not statistically significant (P=0.119).Conclusion: The expressions of ER,PR and Her-2 were discordant between primary lesion and lymph node in the breast cancer patients, and the discordance may reflect the prognosis of these patients.The patients with discordant expressions of ER,PR and Her-2 in the primary lesion and the lymph node metastasis need more individualized diagnosis and treatment.

Key words: breast neoplasms, axillary lymph node, estrogen receptor, progestin receptor, human epidermal growth factor receptor-2