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Immunohistochemical assessment for estrogen receptor and progesterone receptor status in breast cancer: Analysis for a cut-off point as the predictor for endocrine therapy

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Abstract

Background

An immunohistochemical (IHC) method is commonly used for determining estrogen receptor (ER) and progesterone receptor (PR) status in breast cancer. However, the proper cut-off points of IHC have not been established. Cut-off points for ER and PR status as predictive factors for endocrine therapy are needed.

Methods

A total of 249 cases of female breast cancer were enrolled. ER and PR status by IHC were analyzed using the proportion of stained cells and staining intensity by Allred’s score.

Results

Proportion score (PS) and intensity score (IS) were related to enzyme immunoassay (EIA) titers, for both in ER and PR(p < 0.0001, all). PS correlated with IS in both ER and PR (R=0.47 and 0.41,respectively). ER status by IHC was related to tumor size and lymph node status, while PR was related to tumor size and menopausal status. In 152 patients who received endocrine therapy with a median follow-up term of 38 months, differences in disease-free survival were most significant using a cut-off point of PS 3 which indicated more than 10% of cells stained positively for both ER and PR(p = 0.0007 and 0.0087, respectively). In addition, combination analysis of ER and PR using this cut-off point revealed a notable prognostic difference.

Conclusion

A 10% staining proportion may be an acceptable cut-off point for both ER and PR status by IHC, in terms of predicting response to endocrine therapy in breast cancer.

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Abbreviations

ER:

Estrogen receptor

PR:

Progesterone receptor

HR:

Hormone receptor

EIA:

Enzyme immunoassay

IHC:

Immunohistochemistry

LBA:

Ligand-binding assay

PS:

Proportion score

IS:

Intensity score

TS:

Total score

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Authors and Affiliations

  1. Department of Surgery, Osaka City General Hospital, 2-13-22 Miyakojima-Hondori, Miyakojima-ku, 534-0021, Osaka, Japan

    Yoshinari Ogawa & Katsumi Ikeda

  2. Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Japan

    Yoshinari Ogawa, Yasuyuki Kato, Tsutomu Takashima, Bunzo Nakata, Tetsuro Ishikawa & Kosei Hirakawa

  3. Department of Pathology, Tohoku University Hospital, Japan

    Takuya Moriya & Mitsue Oguma

  4. Osaka Medical Prison, Japan

    Yasuyuki Kato

Authors
  1. Yoshinari Ogawa
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  2. Takuya Moriya
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  3. Yasuyuki Kato
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  4. Mitsue Oguma
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  5. Katsumi Ikeda
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  6. Tsutomu Takashima
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  7. Bunzo Nakata
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  8. Tetsuro Ishikawa
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  9. Kosei Hirakawa
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Ogawa, Y., Moriya, T., Kato, Y. et al. Immunohistochemical assessment for estrogen receptor and progesterone receptor status in breast cancer: Analysis for a cut-off point as the predictor for endocrine therapy. Breast Cancer 11, 267–275 (2004). https://doi.org/10.1007/BF02984548

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  • DOI: https://doi.org/10.1007/BF02984548

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