Rieko Nishimura1,2, Yuya Murata3, Kiyoshi Mori4, Katsushige Yamashiro5, Kazuya Kuraoka6, Shu Ichihara2, Kenichi Taguchi7, Hiroyoshi Suzuki8, Masahiro Ito9, Natsumi Yamashita10. 1. Department of Clinical Laboratory, Shikoku Cancer Center, Matsuyama, Japan. 2. Department of Pathology, Nagoya Medical Center, Nagoya, Japan. 3. Department of Pathology, Tokyo Medical Center, Tokyo, Japan. 4. Department of Pathology, Osaka National Hospital, Osaka, Japan. 5. Division of Pathology, Hokkaido Cancer Center, Sapporo, Japan. 6. Department of Diagnostic Pathology, Kure Medical Center and Chugoku Cancer Center, Kure, Japan. 7. Department of Pathology, Kyushu Cancer Center, Fukuoka, Japan. 8. Department of Pathology and Laboratory Medicine, Sendai Medical Center, Sendai, Japan. 9. Clinical Research Center, Nagasaki Medical Center, Omura, Japan. 10. Division of Clinical Biostatistics, Section of Cancer Prevention and Epidemiology, Clinical Research Center, Shikoku Cancer Center, Matsuyama, Japan.
Abstract
OBJECTIVE: We explore the problems associated with the cell block (CB) method for receptor analysis in breast cancer metastases and propose a method for reporting the results. STUDY DESIGN: Nine institutions used the CB method for the analysis of hormone receptors (HRs) and HER2 (human epidermal growth factor receptor 2) protein in cytological specimens of breast cancer metastases in routine practice. The stained slides were independently evaluated by 8 pathologists. Dual in situ hybridization assay was performed in cases of discordant results for HER2 protein. Based on the results, we propose a method for receptor scoring in the CB method. RESULTS: Of 61 specimens, 57 contained tumor cells. Two or more pathologists disagreed on the results for the estrogen receptor, progesterone receptor, and HER2 protein in 3 (5.3%), 13 (22.8%), and 19 (33.3%) cases, respectively. The discrepant results for the HRs were attributed to the presence of a few positive cells or faintly stained cells. The high interobserver discordance rate for HER2 protein was explained by interobserver differences in the scoring criteria. CONCLUSION: The use of categorical scoring into positive and negative is recommended for evaluating the HR expressions. Use of strict criteria for HER2 protein 2+ and 3+ cases is recommended, as HER2-positive cases should not be missed.
OBJECTIVE: We explore the problems associated with the cell block (CB) method for receptor analysis in breast cancer metastases and propose a method for reporting the results. STUDY DESIGN: Nine institutions used the CB method for the analysis of hormone receptors (HRs) and HER2 (humanepidermal growth factor receptor 2) protein in cytological specimens of breast cancer metastases in routine practice. The stained slides were independently evaluated by 8 pathologists. Dual in situ hybridization assay was performed in cases of discordant results for HER2 protein. Based on the results, we propose a method for receptor scoring in the CB method. RESULTS: Of 61 specimens, 57 contained tumor cells. Two or more pathologists disagreed on the results for the estrogen receptor, progesterone receptor, and HER2 protein in 3 (5.3%), 13 (22.8%), and 19 (33.3%) cases, respectively. The discrepant results for the HRs were attributed to the presence of a few positive cells or faintly stained cells. The high interobserver discordance rate for HER2 protein was explained by interobserver differences in the scoring criteria. CONCLUSION: The use of categorical scoring into positive and negative is recommended for evaluating the HR expressions. Use of strict criteria for HER2 protein 2+ and 3+ cases is recommended, as HER2-positive cases should not be missed.
Authors: David A Cohen; David J Dabbs; Kristine L Cooper; Milon Amin; Terrell E Jones; Mirka W Jones; Mamatha Chivukula; Giuliana A Trucco; Rohit Bhargava Journal: Am J Clin Pathol Date: 2012-12 Impact factor: 2.493
Authors: Emily S Reisenbichler; Susan C Lester; Andrea L Richardson; Deborah A Dillon; Amy Ly; Jane E Brock Journal: Am J Clin Pathol Date: 2013-10 Impact factor: 2.493
Authors: Antonio C Wolff; M Elizabeth H Hammond; David G Hicks; Mitch Dowsett; Lisa M McShane; Kimberly H Allison; Donald C Allred; John M S Bartlett; Michael Bilous; Patrick Fitzgibbons; Wedad Hanna; Robert B Jenkins; Pamela B Mangu; Soonmyung Paik; Edith A Perez; Michael F Press; Patricia A Spears; Gail H Vance; Giuseppe Viale; Daniel F Hayes Journal: J Clin Oncol Date: 2013-10-07 Impact factor: 44.544