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Immunohistochemistr...
Immunohistochemistry compared to cytosol assays for determination of estrogen receptor and prediction of the long-term effect of adjuvant tamoxifen
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- Khoshnoud, Mahmoud R. (author)
- Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
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- Löfdahl, Britta (author)
- Uppsala universitet,Institutionen för immunologi, genetik och patologi,Department of Pathology, Uppsala University Hospital, Sweden
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- Fohlin, Helena (author)
- Linköpings universitet,Östergötlands Läns Landsting,Onkologiskt centrum,Hälsouniversitetet
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- Fornander, Tommy (author)
- Karolinska Institutet,Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
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- Stål, Olle (author)
- Linköpings universitet,Onkologi,Hälsouniversitetet
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- Skoog, Lambert (author)
- Karolinska Institutet,Department of Pathology, Karolinska University Hospital, Stockholm, Sweden
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- Bergh, Jonas (author)
- Karolinska Institutet,Cancer Center, Karolinska Institute, Stockholm Sweden and Medical Breast Unit, Christie Hospital, Manchester, UK
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- Nordenskjöld, Bo (author)
- Linköpings universitet,Onkologi,Hälsouniversitetet
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(creator_code:org_t)
- 2010-10-19
- 2011
- English.
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In: Breast Cancer Research and Treatment. - : Springer Science and Business Media LLC. - 0167-6806 .- 1573-7217. ; 126:2, s. 421-430
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Abstract
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- The purpose of this study is to compare immunohistochemistry (IHC) and cytosol-based assays for determination of estrogen receptor (ER) and prediction of response to adjuvant tamoxifen treatment in postmenopausal women with early-stage invasive breast cancer. The Stockholm Breast Cancer Study Group conducted a randomized trial during 1976 through 1990 comparing adjuvant tamoxifen versus control. The patients were stratified according to tumor size and lymph node status in high-risk and low-risk groups. In this study we evaluated 683 patients with "low risk" breast cancer (size a parts per thousand currency sign30 mm, lymph node-negative) for whom ER status had been determined by both the cytosol assays and IHC at one pathology laboratory. The median follow-up was 17 years. Six hundred eighty-three patients had tumors with ER determined by both methods, 536 (78.5%) were ER-positive by cytosol assays using the cutoff level at a parts per thousand yen0.05 fmol/mu g DNA and 539 patients were ER-positive (79%) by IHC using the cutoff level at a parts per thousand yen10% cell stained. Thirty-nine tumors (5.7%) were ER-positive by cytosol but not by IHC, whereas the opposite pattern was found for 42 cases (6.1%). Only seven tumors had stained cells between 0 and 9% by IHC. The concordance between IHC and cytosol assays was high (88%). The kappa statistic was 0.65, 95% CI 0.58-0.72. Among patients classified as ER-negative no therapeutic benefit from tamoxifen was observed. Among patients with ER-expressing tumors, tamoxifen resulted in significantly better recurrence-free survival irrespective of the method (IHC: HR, 0.53, P < 0.001; cytosol: HR, 0.53, P < 0.001). The effect on overall survival was not statistically significant probably due to the limited sample size. Both IHC and cytosol assay accurately predict long-term response to adjuvant tamoxifen.
Keyword
- Breast cancer
- Estrogen receptor
- Tamoxifen
- Cytosol
- Immunohistochemical
- MEDICINE
- MEDICIN
Publication and Content Type
- ref (subject category)
- art (subject category)
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