Assessment of hormonal receptors and Her-2/neu status in breast cancer using cell block: a case study

Nyagol, Joshua; Kisato, V.; Ochuk, Willis; Wakio, M.

doi:10.1007/s12558-013-0279-4

Cited by 2 publications

(3 citation statements)

References 19 publications

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“…Previously paraffin embedded tissue sections IHC has been the method of choice for assessing ER, PR and HER2/neu status in patients with breast carcinoma. The present study perfectly agrees with the recent studies on assessment of HER2/neu, PR and ER expression patterns on cell blocks 15,16,17 . Based on the study outcome, we concluded that cell blocks prepared from FNA can be adequately used to assess HER2/neu and hormonal receptor expression patterns in patients with breast cancer provided that the FNA contains enough tumor cells (high cellularity).…”

Section: Discussionsupporting

confidence: 93%

Validation of Fine Needle Aspiration Cytology in the Evaluation of Human Epidermal Growth Factor Receptor-2 and Hormonal Receptor Expression Patterns in Breast Cancer Patients

Christine¹

2019

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Introduction: Breast cancer is defined as a group of malignant neoplasms and accounts for up to 22% of all female cancers. It rarely occurs in men. In breast cancer, the level of human epidermal growth factor receptor-2 (HER2) over expression is said to be a prognostic molecular marker that is used for selection of patients for targeted HER2therapy. Estrogen receptor (ER) and progesterone receptor (PR) are both prognostic and predictive markers for response to hormonal therapy. Fine-needle aspiration (FNA) provides highly cellular sample. Assessment of HER2, ER and PR status in FNA samples is very important clinically. The study was aimed to validate that fine needle aspiration cytology can be used to assess HER2, ER and PR expression patterns in patients with breast cancer. Methods: Cell blocks were prepared from FNA material collected from 39 newly diagnosed breast cancer patients and immunocytochemistry (ICC) for HER2 and the hormonal receptors, ER and PR was done. Immunohistochemistry (IHC) for HER2, ER and PR was also done on the corresponding biopsy sections. Both positive and negative quality controls were included in the experiments. The Allred scoring system was used to determine the positivity for PR and ER. The overexpression of HER2 was assessed using a scale of 0-3+ for both proportion and intensity whereby 3+ and above was considered positive. The cell block results were compared with core biopsy results and breast cancer classified into various types as luminal A, luminal B, HER2 over expression and the triple negative. The results were then compared with those of core biopsy immunohistochemistry using ANOVA. Kappa statistics was done to check the level of agreement. Results: Cell block and biopsy results were compared, for ER there was a concordance of 32/35(91.4%) r=0.842 Sensitivity of 83.3% and specificity of 85.0%. For PR the concordance was 32/35(91.4%) r=0.842 with sensitivity of 84.2% and specificity of 84.2%. For HER2 the concordance was 34/35 (97.1%) r=0.925 with a sensitivity of 88.9% and a specificity of 96.3%/. There was moderate agreement between the two methods, k=0.719, p<0.001 Conclusion: The results obtained from FNA cell blocks are reliable when compared with pairedparaffin embeddedtissue blocks. Therefore, HER2, ER and PR can be adequately assessed using cell blocks prepared from FNA material.

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Section: Discussionsupporting

confidence: 93%

Validation of Fine Needle Aspiration Cytology in the Evaluation of Human Epidermal Growth Factor Receptor-2 and Hormonal Receptor Expression Patterns in Breast Cancer Patients

Christine¹

2019

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“…These expression patterns are within the range of earlier studies, which reported overexpression of ER/PR among African breast cancer cases with estimates ranging between 18% and 72% . [6,8,9,14] Human epidermal growth factor receptor-2 (HER-2/neu) was positive in 13 % of breast cancer cases using cell block. The frequency of HER2/neu overexpression varies in Kenyan studies, Bird et al reported HER2/neu overexpression in 26% of breast cancer cases among women in Kenya, [6] Nyagol et al 20.26%, [8] while a recent study by Sayed et al showed 17% of HER2/neu overexpression by immunohistochemistry.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the benefit of using a cell block is that it is cheaper than core needle biopsy, serial sections can be obtained, the use of same antibodies as those of formalin fixed histological sections [11,12] and is also recommended in case of recurrent disease especially in nodal metastasis. The use of FNAC for determination of ER, PR and HER-2/neu expression patterns has not been adequately explored in poor resource setting especially in developing countries including Kenya [9,14] , furthermore breast cancer stratification into subtypes based on expression patterns of ER, PR and HER-2/neu using FNAC is lacking. Fine needle aspiration cytology is performed by making several passes within the lump using a needle to obtain the cell sample.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of human epidermal growth factor receptor-2 and hormonal receptor expression patterns in breast cancer from fine needle aspiration cytology

Kyama¹

2018

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Introduction: Breast cancer is the most common cancer among women, accounting for 22% of all female cancers. In breast cancer, the overexpression of human epidermal growth factor receptor-2 (HER-2/neu) is a prognostic marker indicated for stratification of patients for HER-2/neu targeted therapies, while estrogen receptor (ER) and progesterone receptors (PR) are additional prognostic markers in patients with early stage breast cancer and predictive for response to hormonal therapies. Fine needle aspiration cytology (FNAC), can provide enough cellular sample and evaluation of ER, PR and HER2/neu expression patterns has relevant clinical application because the sample can be collected before surgery and help plan management of breast cancer patients. The aim of the study was to evaluate and classify breast cancer by examining HER-2/neu, ER and PR expression patterns using cellblocks. Methods: A prospective cross-sectional study was carried out using FNAC samples from 30 patients with breast cancer. The ER, PR and HER2/neu protein overexpression patterns were determined by immunocytochemistry. Breast cancer cases were considered positive for ER and PR when 10% or more tumor cells were stained. The HER-2/neu overexpression was assessed on a scale of 0 to 3+ and a score of 3+ was considered positive. Results: Estrogen receptor positivity was observed in 50% of breast cancer cases, while PR positivity in 47% of the cases and HER2/neu was overexpressed in 13% of breast cancer cases. Conclusion: Immunocytochemistry performed on cell block is a feasible method for evaluation of ER, PR and HER-2/neu status in breast cancer, especially when the cellblock has adequate tumor cells.

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Assessment of hormonal receptors and Her-2/neu status in breast cancer using cell block: a case study

Cited by 2 publications

References 19 publications

Validation of Fine Needle Aspiration Cytology in the Evaluation of Human Epidermal Growth Factor Receptor-2 and Hormonal Receptor Expression Patterns in Breast Cancer Patients

Validation of Fine Needle Aspiration Cytology in the Evaluation of Human Epidermal Growth Factor Receptor-2 and Hormonal Receptor Expression Patterns in Breast Cancer Patients

Evaluation of human epidermal growth factor receptor-2 and hormonal receptor expression patterns in breast cancer from fine needle aspiration cytology

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