Frequency and reliability of oestrogen receptor, progesterone receptor and HER2 in breast carcinoma determined by immunohistochemistry in Australasia: results of the RCPA Quality Assurance Program

Francis, Glenn; Dimech, Margaret; Giles, Leanne; Hopkins, Alison

doi:10.1136/jcp.2006.044701

Cited by 42 publications

(23 citation statements)

References 23 publications

(35 reference statements)

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“…The proportion of breast cancers defined as ER-positive (87.47%) or PR-positive (75.18%) is higher than literaturereported proportions for ER (75%) and PR (55%) [7,14,48,49]. Improved laboratory sensitivity for detecting ER, different quantification techniques, and dichotomous cutoff values for assessing ER and PR account for important interlaboratory variability [36,50,51].…”

Section: Discussionmentioning

confidence: 89%

“…HER-2 as a poor prognostic marker is already now being affected by adjuvant trastuzumab therapy and triple negative tumors may, anyway, eventually become the subgroup with the worst DFI. Also, patients with a triple negative breast cancer suffer from more limited treatment options and exhibit inherent aggressive tumour characteristics as expressed by their high median NPI score [48,49] (Tables 1 and 2).…”

Section: Discussionmentioning

confidence: 99%

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Short-term outcome of primary operated early breast cancer by hormone and HER-2 receptors

Brouckaert

Pintens

Belle

et al. 2008

Breast Cancer Res Treat

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Introduction Prognostic subgroup classification of operable breast cancers using cDNA clustering of breast cancer-related genes resembles the classification based on the combined immunohistochemical (IHC) expression of the hormone and HER-2 receptors. We here report the shortterm disease-free interval (DFI) of operable breast cancers by their joint hormone receptor/HER-2 phenotype. Patients and methods Short-term follow-up (FU) of a prospective cohort of 1,958 breast-cancer patients primary operated at our institution between 2000 and 2005. Receptors were evaluated using IHC. Steroid receptors were considered positive for any nuclear staining; HER-2 for strong (3+) membrane staining or positive fluorescence in situ hybridization (FISH). Kaplan-Meier (KM) DFI curves were calculated for any relapse defined as a local, regional, contralateral, or distant breast cancer event for the six predefined breast cancer subgroups: ER + PR + HER-2 -(PPN), ER + PR -HER-2 -(PNN), ER + PR + HER-2 + (PPP), ER -PR -HER-2 -(NNN), ER -PR -HER-2 + (NNP), and ER + PR -HER-2 + (PNP). P-values were calculated for comparison of the six different survival curves using two possible adaptations for multiple testing. A multivariate model for the receptors predicting DFI did incorporate local and systemic adjuvant therapy. Results Median patient age was 57 years (ranges 26-96) and median FU was 3.35 years. Overall, DFI at median FU was 91%; 94% for PPN, 89% for PNN, 86% for NNN, 81% for PPP, 80% for PNP, and 76% for NNP cases. Some receptor subgroups had a significantly better DFI than others based on multiple testing, especially when the PPN group was compared against the four most frequent subtypes. The multivariate model with local and systemic adjuvant therapy confirmed the prognostic value of ER, PR, and HER-2 for short-term DFI. Conclusion It is possible to distinguish short-term prognostic breast cancer subgroups only on the basis of ER, PR, and HER-2 even when stratified for local and systemic adjuvant therapy. While gene expression profiles based on microarray data of over hundreds of genes will probably teach us much about breast cancer biology, heterogeneity, and prognosis, we emphasize the important short-term prognostic value of currently used IHC markers for ER, PR, and HER-2.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Short-term outcome of primary operated early breast cancer by hormone and HER-2 receptors

Brouckaert

Pintens

Belle

et al. 2008

Breast Cancer Res Treat

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show abstract

“…The cumulated ratio of ER and PR expression in breast tumors of Indian women is found to be much lower than that of Western population, where >50% are co-positive for ER and PR (Barnes et al, 1996). Studies from Canada and Australia also reported that 73% and 59% of the BC were ER positive while 58.10% and 61% were PR positive respectively (Rhodes et al, 2000;Francis et al, 2007).…”

Section: Discussionmentioning

confidence: 94%

HER-2/neu Status: A Neglected Marker of Prognostication and Management of Breast Cancer Patients in India

Zubeda¹,

Kaipa²,

Shaik³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Categorizing breast tumors based on the ER, PR and HER/Neu 2 receptor status is necessary in order to predict outcome and assist in management of breast cancer. Herfe we assessed this question in South Indian patients. Materials and Methods: A total of 619 formalin fixed paraffin embedded breast tumor tissues were collected from pathology archives after receipt of ethical clearance. With the help of primary and secondary conjugated antibodies, expression status of ER, PR and HER2/neu was determined. All the experimental data were assessed for correlations with histopathological features of tumors and clinical presentation of the subjects. Results: In the present study, the ages ranged from 20-87 years with a mean of 50.0±12.q years, and majority of the tumors (84%) were of infiltrating duct cell carcinoma type. Assessment of ER, PR and Her-2/neu expression showed that 46% were triple negative. Interestingly, an inverse relation between ER, PR and HER-2/neu was apparent in 41.2% (p<0.0001) of the tumors, of which 24.5% (p<0.0001) were ER and PR co-negative but HER-2 positive. Conclusions: ER and PR positive tumors are less common (i.e<30%) compared to HER-2/neu positive tumors (i.e>50%) in Indian breast cancer patients, underlining the need for effective diagnostic screening and specific therapeutic managements in order to improve the survival rate of patients in low resource countries such as India.

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“…Quality assurance measures are crucial to ensure a sufficient standard of staining quality and accurate interpretation to minimize false positives and negatives, which could lead to inappropriate treatment choices and detrimentally effect patient care. 35 The early studies evaluating ALK fusion immunohistochemistry reported limitations of sensitivity, describing an absence of immunoreactivity in ALK fusion positive NSCLCs. 29,36 In addition, immunohistochemistry can be hindered by poor fixation, variability in staining protocols, limited expertise by pathologists and can be hampered by small biopsies containing minimal tumor cells.…”

Section: Discussionmentioning

confidence: 99%

Testing for ALK rearrangement in lung adenocarcinoma: a multicenter comparison of immunohistochemistry and fluorescent in situ hybridization

et al. 2013

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Rearrangements of anaplastic lymphoma kinase (ALK) gene in non-small cell lung cancer (NSCLC) define a molecular subgroup of tumors characterized clinically by sensitivity to ALK tyrosine kinase inhibitors such as crizotinib. Although ALK rearrangements may be detected by reverse transcriptase-PCR, immunohistochemistry or fluorescence in situ hybridization (FISH), the optimal clinical strategy for identifying ALK rearrangements in clinical samples remains to be determined. We evaluated immunohistochemistry using three different antibodies (ALK1, 5A4 and D5F3 clones) to detect ALK rearrangements and compared those with FISH. We report the frequency and clinicopathologic features of lung cancers harboring ALK translocations in 594 resected NSCLCs (470 adenocarcinomas; 83 squamous carcinomas, 26 large cell carcinomas and 15 other histological subtypes) using a tissue microarray approach. We identified an ALK gene rearrangement in 7/594 cases (1%) by FISH and all anti-ALK antibodies correctly identified the seven ALK-positive cases (100% sensitivity), although the intensity of staining was weak in some cases. These data indicate that the use of antibodies with high sensitivity and avidity to ALK may provide an effective pre-screening technique to complement the more expensive and labor-intensive approach of ALK FISH testing.

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Frequency and reliability of oestrogen receptor, progesterone receptor and HER2 in breast carcinoma determined by immunohistochemistry in Australasia: results of the RCPA Quality Assurance Program

Cited by 42 publications

References 23 publications

Short-term outcome of primary operated early breast cancer by hormone and HER-2 receptors

Short-term outcome of primary operated early breast cancer by hormone and HER-2 receptors

HER-2/neu Status: A Neglected Marker of Prognostication and Management of Breast Cancer Patients in India

Testing for ALK rearrangement in lung adenocarcinoma: a multicenter comparison of immunohistochemistry and fluorescent in situ hybridization

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