Review of Estrogen Receptor, Progesterone Receptor, and HER-2/neu Immunohistochemistry Impacts on Treatment for a Small Subset of Breast Cancer Patients Transferring Care to Another Institution

2013 ◽  
Vol 137 (11) ◽  
pp. 1660-1663 ◽  
Author(s):  
Julie M. Jorns ◽  
Patrick Healy ◽  
Lili Zhao
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Progesterone Receptor ◽  
Cancer Patients ◽  
Treatment Recommendation ◽  
Small Subset ◽  
Breast Cancer Patients ◽  
Number Of Patients ◽  
Her 2 ◽  
Pathology Review

Context.—Estrogen receptor (ER), progesterone receptor (PR), and HER-2/neu studies are variably submitted for pathology review but are influential in treatment choices for breast cancer patients seeking second opinion or transferring care. Objective.—To determine the frequency of interinstitutional discordance for the interpretation of ER/PR and HER-2/neu immunohistochemical slides and assess the resulting clinical significance. Design.—One thousand one hundred thirty-nine ER, 1111 PR, and 663 HER-2/neu immunohistochemistry stains from 1139 cases were reviewed at contributing and referral centers and compared for concordance and clinical impact of discordance. Results.—Interinstitutional concordance for individual stains was excellent (ER: κ = 0.93; PR: κ = 0.90; HER-2/neu: κ = 0.93). One hundred four (9.1%) had interinstitutional discordance in 1 or more stains; however, the majority of the discordance was clinically insignificant. Seven patients (0.6%) had a clinically significant change in treatment recommendation based on review and 2 (0.2%) had interpretation changes that would likely have resulted in treatment change had they not already completed therapy. Two patients (0.2%) had change in treatment despite concordant interpretations. Conclusions.—Overall, there was excellent interinstitutional concordance for pathology review of ER, PR, and HER-2/neu immunohistochemistry stains. However, a small but significant number of patients (0.8%) received potential benefit from review, justifying inclusion of these slides along with other pathology slides to be reviewed for all breast cancer patients being seen at another institution who have not yet completed hormonal and/or chemotherapy.

scholarly journals Estrogen receptor and progesterone receptor status of breast cancer patients of eastern India: A multi-institutional study

2018 ◽  
Vol 07 (01) ◽  
pp. 05-06 ◽  
Author(s):  
Koushik Chatterjee ◽  
Gautam Bhaumik ◽  
Bhargab Chattopadhyay
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Progesterone Receptor ◽  
Cancer Patients ◽  
Tertiary Care ◽  
Breast Cancer Patients ◽  
Eastern India ◽  
Number Of Patients ◽  
Er Positive ◽  
American Society

Abstract Context: There is a paucity of any significant data on the estrogen receptor (ER) and progesterone receptor (PR) status of breast cancer patients from the eastern part of India. Aims: This study aims to document the ER and PR status of breast cancer patients in the eastern Indian population, as catered by two premier tertiary care hospitals in Kolkata. Subjects and Methods: All breast cancer patients registered between January 1, 2013 and December 31, 2015, in the Departments of Oncology, of IPGMER and SSKM Hospitals and R. G. Kar Medical College and Hospital, Kolkata, who had at least undergone a core biopsy or surgery, were analyzed retrospectively for documentation of their ER and PR status, using the 2010 American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) interpretation guidelines. Results: Over a period of 3 years, a total of 927 patients were included for the study. A total of 825 (89%) patients had their ER and PR data available for evaluation. ER and PR positive was seen in 312 (37.82%) patients, ER and PR negative in 399 (48.36%) patients, ER positive and PR negative in 71 (8.6%) patients, and ER negative and PR positive results was found in 43 (5.21%) patients. Conclusions: This is the first multi-institutional documentation of ER and PR status from eastern India, having a modest number of patients and one of the earliest documentations using the latest ASCO/CAP interpretation guidelines. These findings resemble the data from the south and also reiterate the fact that majority of the Indian breast cancer patients are still ER and PR negative in spite of the changes in the interpretation guidelines.

scholarly journals Ki-67 Expression is a Significant Prognostic Factor Only When Progesterone Receptor Expression is Low in Estrogen Receptor-Positive and HER2-Negative Early Breast Cancer

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Young-Joon Kang ◽  
Han-Byoel Lee ◽  
Yun Gyoung Kim ◽  
JaiHong Han ◽  
Yumi Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Prognostic Factor ◽  
Progesterone Receptor ◽  
Cancer Patients ◽  
Early Breast Cancer ◽  
Receptor Expression ◽  
Breast Cancer Patients ◽  
Ki 67 ◽  
End Point

Objective. While the value of Ki-67 has been recognized in breast cancer, controversy also exists. The goal of this study is to show the prognostic value of Ki-67 according to progesterone receptor (PgR) expression in patients who have estrogen receptor- (ER-) positive, human epidermal growth factor receptor 2- (HER2-) negative early breast cancer. Methods. The records of nonmetastatic invasive breast cancer patients who underwent surgery at a single institution between 2009 and 2012 were reviewed. Primary end point was recurrence-free survival (RFS), and secondary end point was overall survival (OS). Ki-67 and PgR were assessed with immunohistochemistry for the tumor after surgery. Results. A total of 1848 patients were enrolled in this study. 223 (12%) patients had high (≥10%) Ki-67, and 1625 (88%) had low Ki-67 expression. Significantly worse RFS and OS were observed in the high vs. low Ki-67 expression only when the PgR was low (<20%) (p<0.001 and 0.005, respectively, for RFS and OS). There was no significant difference in RFS and OS according to Ki-67 when the PgR was high (p=0.120 and 0.076). RFS of four groups according to high/low Ki-67 and PgR expression was compared. The low PgR and high Ki-67 expression group showed worst outcome among them (p<0.001). In a multivariate analysis, high Ki-67 was an independent prognostic factor when the PgR was low (HR 3.05; 95% CI 1.50–6.19; p=0.002). Conclusions. Ki-67 had a value as a prognostic factor only under low PgR expression level in early breast cancer. PgR should be considered in evaluating the prognosis of breast cancer patients using Ki-67.

Translational cell study exploring the role of estrogen receptor β expression as a predictive and/or prognostic factor in breast cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e22185-e22185
Author(s):  
S. Saji ◽  
N. Honma ◽  
M. Hirose ◽  
S. Hayashi ◽  
K. Kuroi
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Cell Line ◽  
Cancer Patients ◽  
Triple Negative ◽  
Breast Cancer Patients ◽  
Her 2 ◽  
Mcf 7 ◽  
Cell Study ◽  
Positive Breast Cancer

e22185 Background: We have reported that positive expression of Estrogen receptor β (ERβ) was associated with better prognosis in the early breast cancer patients treated with adjuvant tamoxifen monotherapy (J Clin Oncol. 2008). In addition, this was also true in the ERα-negative/PR-negative/Her-2 negative patients. We explored the biological impact of ERβ in breast cancer cell lines to determine whether these observations were due to its prognostic power or predictive power of response to the therapy. Methods: Since MCF-7 cell was ERβ-negative ERα-positive cell line, we established two stable clones of MCF-7 by introducing ERβ expression vector (β-clone 1, β-clone 2) as the model of ERβ-positive ERα-positive breast cancer. MDA-MB 231 cell was used as ERβ-positive triple-negative cell line. These cells were subjected to proliferation, expression and functional analysis. Results: In western blotting, both β-clone 1 and clone 2 showed decreased expression of PR and Her-2 than parent MCF-7, although there were no differences in ERα expression. Expression of ERβ decreased estradiol (E2) induced proliferation ability and rate of cells in S-phase cycle. PPT (ERα-specific agonist) and DPN (ERβ-specific agonist) did not show any difference in response, and IC 50 for 4 OH-tamoxifen and fulvestrant did not differ among MCF-7, β-clone 1 and clone 2 (0.05–0.1 μM). Whereas, cell death due to deprivation of E2 from 1nM to 1pM was more frequently observed in ERβ-expressing clones than in parent MCF-7 cell. These cell deaths did not involve standard apoptosis pathway with caspase-3/7 activation and PARP cleavage. E2, DPN and PPT did not affect the proliferation of ERβ-positive triple negative MDA-MB 231 cell, and IC 50 for 4-OH tamoxifen was too high (8 μM) to be achieved in clinical pharmacological dose. Conclusions: From our cell study, better prognosis of ERβ-positive breast cancer patient who treated with adjuvant tamoxifen is mainly due to its own favorable biological behavior. However, this prognostic impact may include the favorable response to the treatment, when we use estrogen-deprivation therapy such as aromatase inhibitors (AIs). Additional clinical study in AI users would be required to address this issue. No significant financial relationships to disclose.

Limitations in assessment of ER, PR, and HER2 status of breast cancer patients: Yangon experience.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e11078-e11078
Author(s):  
Yin Yin Mon
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Advanced Technology ◽  
Molecular Profile ◽  
Molecular Testing ◽  
Breast Cancer Patients ◽  
Financial Problem ◽  
Lack Of Information ◽  
Number Of Patients ◽  
Her 2

e11078 Background: Management of breast cancer become individualized nowadays especially in developed countries. Molecular profile of breast cancer is essential to have this management. However, there are still limitations to examine such molecular profile in developing countries like Myanmar. Our aim in this study is to know the number of patients who underwent ER, PR and HER 2 status assessment among breast cancer patients in Myanmar and to analyze types of limitations for the molecular assessment in management of breast cancer. Methods: Total number of 823 breast cancer patients who registered from January 2009 to December 2011 at Medical Oncology Unit of Yangon General Hospital and two private oncology clinics were studied. Results: The age range from 19-80 years and mean age of 44.36 years. Among 823 breast cancer patients, ER, PR and HER 2 status were done in 134 patients (16.28% ) whereas 689 patients( 83.71% ) were not. 604 (87.66%) out of 689 patients who did not undergo profiling were due to financial problem. 60 patients (8.70 %) were found to have lack of information about molecular profiling although they were affordable . 25 patients (3.62 %) lost their tissue due to technological limitation Conclusions: Financial problem is the major limitation to get molecular profile for breast cancer patients in Myanmar. Patients need self expense to do advanced technology examinations in different health care system of our country. In this study we also found out that there was lack of information which leads not to undergo further investigations to some well to do patients. Overall, we believe that molecular technology support with reduced expense will help more patients in future to get better management in breast cancer in Myanmar. Besides, we need to provide update information about molecular testing in breast cancer to not only patients but also health professionals in our country.

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