Histochemical detection of oestrogen receptors in breast carcinoma: A successful technique

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Summary A total of 98 breast aspirates from patients with breast cancer have been fixed and stained for oestrogen receptors using the Abbott ERICA kit. In a preliminary series of 41 aspirates, cytochemical staining index (% cells staining x mean intensity) related to the receptor concentration determined biochemically on a subsequent biopsy with a correlation coefficient of +0.65. In a second series of 56 aspirates examined after lysis and cytocentrifugation, the correlation coefficient was +0.73. For 14 patients, the response of the primary tumour to endocrine therapy was assessed objectively by serial clinical and mammographic measurements (Forrest et al., 1986) and was found to relate strongly to the cytochemical staining of the initial aspirate. The potential and limitations of this technique are discussed.The presence of oestrogen receptors within a breast tumour is now established as an index of both improved prognosis and increased likelihood of response to endocrine therapy (Hawkins, 1985). The generation of monoclonal antibodies against the human oestrogen receptor (Greene et al., 1980) has permitted the development of commercial kits for both biochemical (ER-EIA) and histochemical (ER-ICA) assays by Abbott Laboratories. The results of the latter technique have been shown to correlate well with those of established biochemical, steroid-binding (DCC) methods on biopsies of solid tumour (King et al., 1985;McLelland & Coombes, 1985;McCarty et al., 1985;Hawkins et al., 1986) and the technique has recently been extended to the assessment of receptor status in breast cancer cells collected by needle aspiration (McLelland & Coombes, 1985;Flowers et al., 1985;McLelland et al., 1987;Cavailles et al., 1987;Weintraub et al., 1987). We set out to examine the feasibility of using such a method and to compare the results of the technique with (a) those of our standard DCC assay on solid biopsy, established 15 years ago and (b) response to endocrine therapy in patients with large primary tumours. Methods and materials PatientsAspirates were taken from patients presenting to the departmental clinic for the first time. The patients' ages ranged from 33 to 76 years. Aspirates were obtained by making approximately 10 passes through the tumour using a 21 gauge needle, mainly by two of us (PAL, EDCA). After preparation of smears for diagnostic cytopathology, residual material was used for fixation and cytochemical staining. In one subset of 14 patients with large tumours (>4cm, T2/T3 and one T4), the patient proceeded after aspiration to wedge biopsy for further biochemical and histological investigations prior to initiating endocrine therapy. The response of the primary tumour was monitored objectively by sequential clinical and mammographic measurements (Forrest et al., 1986). Of these patients, five received the LHRH agonist Zoladex (ICI 118630), five aminoglutethimide, two 4-hydroxyandrostenedione and two tamoxifen. One patient was premenopausal, 12 were postmenopausal and one was male. Response was classed as regress...

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confidence: 57%

The cytochemical detection of oestrogen receptors in fine needle aspirates of breast cancer; correlation with biochemical assay and prediction of response to endocrine therapy

Hawkins

Sangster²,

Tesdale³

et al. 1988

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“…However, three of 29 tumours showing no biochemical evidence of ER-protein showed some immunocytochemical staining and conversely -protein (McCarty et al, 1986;Charpin et al, 1986;Hawkins et al, 1986;Reiner et al, 1986;Weintraub et al, 1987;Horsfall et al, 1989).…”

Section: Discussionmentioning

confidence: 99%

Change in the oestrogen receptor status of breast cancer with age – comparison of two types of assay

Gaskell

Sangster²,

Tesdale³

et al. 1992

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Summary The oestrogen receptor (ER) is considered to be an essential component of the mechanism of response of a breast tumour to endocrine therapy, but ER measurements have proved to have only modest predictive value. In the present study, we have examined ER status by both immunocytochemical assay (ER-ICA) on a fine needle aspirate and by radioligand-binding assay (DCC) on an excised portion of tumour.There was a correlation between the ER level detected by the two assays (Spearman's r = 0.77 for DCC versus ER-ICA staining intensity, r = 0.70 for DCC versus ER-ICA percentage of cells stained, P< 0.0001, n = 137 in each case). Each assay showed an increasing proportion of ER + ve results with increasing patient age. In the case of ER + ve tissues only, while ER concentration by DCC assay increased steadily with age (r = 0.39, P <0.0001, n = 108), the ER-ICA assay revealed that, staining intensity increased with age (r = 0.26, P = 0.001, n = 149) but the percentage of cells stained did not (r = 0.08, P = NS, n = 149).It is concluded that increasing endocrine responsiveness with advancing age could reflect the increasing proportion of ER + ve tumours with increased levels of ER per cell (as indicated by staining intensity) rather than increasing proportion of ER + ve cells.Response to endocrine therapy depends, to a large extent, on the presence or absence of oestrogen receptors (Lippman & Allegra 1980;Manni et al., 1980;Furr & Jordan, 1984;Hawkins 1985;Oriana et al., 1987). In addition, response and oestrogen receptor status have both been reported to change with age (Patterson et al., 1981;Beex & Koenders, 1984 (Hawkins et al., 1975(Hawkins et al., , 1981

“…It is reported to have a strong positive correlation with standard radioligand binding assays (Hawkins et al, 1986;Johnson et al, 1987;McCarty et al, 1986;Charpin et al, 1986;Ozzello et al, 1986;DeSombre et al, 1986;Jonat et al, 1986) and is of comparable sensitivity for ER positive tissue (qv) to both IEF and DCC assay in our own laboratory (Jackson et al, 1989).…”

Section: Isoelectric Focusingmentioning

confidence: 97%

Classical oestrogen receptor is not detectable in pancreatic adenocarcinoma

Taylor

Teasdale²,

Cowen³

et al. 1992