Publication: Assessment of estrogen receptor low positive status in breast cancer: Implications for pathologists and oncologists
Authors
Fusco, Nicola ; Ragazzi, Moira ; Sajjadi, Elham ; Venetis, Konstantinos ; Piciotti, Roberto ; Morganti, Stefania ; Santandrea, Giacomo ; Fanelli, Giuseppe Nicolò ; Despini, Luca ; Invernizzi, Marco ; Cerbelli, Bruna ; Scatena, Cristian ; Criscitiello, Carmen
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Publisher
Universidad de Murcia, Departamento de Biologia Celular e Histiologia
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DOI
https://doi.org/10.14670/HH-18-376
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info:eu-repo/semantics/article
Description
Abstract
Estrogen receptor (ER) status assessment by
immunohistochemistry (IHC) is the gold standard test
for the identification of patients with breast cancer who
may benefit from endocrine therapy (ET). Whilst most
ER+ breast cancers have a high IHC score, about 3% of
cases display a low positivity, with 1% to 10% of cells
being weakly stained. These tumors are generally
classified within the luminal-like category; however,
their risk profile seems to be more similar to that of ERnegative breast cancers. The decision on ET for patients
with a diagnosis of ER-low breast cancer should be
carefully considered in light of the risks and possible
benefits of the treatment. Potential pitfalls hinder
pathologists and oncologists from establishing an
appropriate threshold for "low positivity". Furthermore,
several pre-analytical and analytical variables might
trouble the pathological identification of these clinically
challenging cases. In this review, we sought to discuss
the adversities that can be accounted for the pathological
identification of ER-low breast cancers in real-world
clinical practice, and to provide practical suggestions for
the perfect ER testing in light of the most updated
recommendations and guidelines.
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Citation
Histology and Histopathology Vol. 36, nÂş12 (2021)
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