Bimodal Frequency Distribution of Estrogen Receptor Immunohistochemical Staining Results in Breast Cancer
- 1 January 2005
- journal article
- Published by Oxford University Press (OUP) in American Journal of Clinical Pathology
- Vol. 123 (1) , 16-20
- https://doi.org/10.1309/hcf0-35n9-wk40-etj0
Abstract
Immunohistochemical analysis is used routinely to determine the estrogen receptor (ER) status of breast cancers in paraffin sections. However, lack of standardization has raised concerns that weakly ER+ tumors often are classified erroneously as ER–. To determine the frequency of weakly ER+ tumors, we reviewed ER immunostains of 825 breast cancers. For each case, we estimated the proportion of ER+ tumor cells and also determined an Allred score (which results in scores of 0 or 2 through 8, based on staining intensity and proportion of positive cells). In 817 cases (99.0%), tumor cells showed complete absence of staining or staining in 70% or more of the cells. Similarly, 818 cases (99.2%) exhibited Allred scores of 0 or of 7 or 8. Thus, with the immunohistochemical method used in our laboratory, ER staining is essentially bimodal. The overwhelming majority of breast cancers are either completely ER– or unambiguously ER+, and cases with weak ER immunostaining are rare.Keywords
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