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  • Khoshnoud, Mahmoud R.Department of Oncology, Karolinska University Hospital, Stockholm, Sweden (author)

Immunohistochemistry compared to cytosol assays for determination of estrogen receptor and prediction of the long-term effect of adjuvant tamoxifen

  • Article/chapterEnglish2011

Publisher, publication year, extent ...

  • 2010-10-19
  • Springer Science and Business Media LLC,2011
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-150679
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-150679URI
  • https://doi.org/10.1007/s10549-010-1202-7DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:122134804URI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-67030URI

Supplementary language notes

  • Language:English
  • Summary in:English

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Classification

  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • 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.

Subject headings and genre

  • Breast cancer
  • Estrogen receptor
  • Tamoxifen
  • Cytosol
  • Immunohistochemical
  • MEDICINE
  • MEDICIN

Added entries (persons, corporate bodies, meetings, titles ...)

  • Löfdahl, BrittaUppsala universitet,Institutionen för immunologi, genetik och patologi,Department of Pathology, Uppsala University Hospital, Sweden (author)
  • Fohlin, HelenaLinköpings universitet,Östergötlands Läns Landsting,Onkologiskt centrum,Hälsouniversitetet(Swepub:liu)helfo18 (author)
  • Fornander, TommyKarolinska Institutet,Department of Oncology, Karolinska University Hospital, Stockholm, Sweden (author)
  • Stål, OlleLinköpings universitet,Onkologi,Hälsouniversitetet(Swepub:liu)ollst87 (author)
  • Skoog, LambertKarolinska Institutet,Department of Pathology, Karolinska University Hospital, Stockholm, Sweden (author)
  • Bergh, JonasKarolinska Institutet,Cancer Center, Karolinska Institute, Stockholm Sweden and Medical Breast Unit, Christie Hospital, Manchester, UK (author)
  • Nordenskjöld, BoLinköpings universitet,Onkologi,Hälsouniversitetet(Swepub:liu)bono64 (author)
  • Department of Oncology, Karolinska University Hospital, Stockholm, SwedenInstitutionen för immunologi, genetik och patologi (creator_code:org_t)

Related titles

  • In:Breast Cancer Research and Treatment: Springer Science and Business Media LLC126:2, s. 421-4300167-68061573-7217

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