Immunohistochemical detection of estrogen receptor, progesterone receptor and human epidermal growth factor receptor 2 in formalin-fixed breast carcinoma cell block preparations: Correlation of results to corresponding tissue block (needle core and excision) samples

• Published in: Diagnostic cytopathology 2013-03, Vol.41 (3), p.192-198
• Main Authors: Kinsella, Mary D., Birdsong, George G., Siddiqui, Momin T., Cohen, Cynthia, Hanley, Krisztina Z.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - genetics; Adenocarcinoma - metabolism; Adenocarcinoma - secondary; Biomarkers, Tumor - metabolism; Biopsy, Needle; breast cancer; Breast Neoplasms - genetics; Breast Neoplasms - metabolism; Breast Neoplasms - pathology; cell block; Female; fine-needle aspiration; Fixatives; Formaldehyde; Gene Amplification; HER2; Humans; Immunohistochemistry; Lymph Nodes - pathology; Lymphatic Metastasis; Mastectomy; Receptor, ErbB-2 - genetics; Receptor, ErbB-2 - metabolism; Receptors, Estrogen - metabolism; Receptors, Progesterone - metabolism; Reproducibility of Results
• ISSN: 8755-1039; 1097-0339
• DOI: 10.1002/dc.21815

Evaluation of ER, PR and Her 2 are routinely performed on breast carcinomas. For accurate detection of these markers, compliance with the ASCO/CAP guidelines is recommended. Our previous study showed that alcohol fixation did not affect ER results when alcohol‐fixed cell block (CB) sections were compared to formalin‐fixed tissue sections, while PR and Her2 showed less concordance. The aim of this study was to evaluate and to compare ER, PR and Her2 IHC results on formalin‐fixed CB sections to those observed on subsequent surgical (needle core or resection) specimens (SS). Fifty cases of formalin fixed CB samples obtained from primary (18%) and metastatic (82%) breast carcinomas were studied, all of which had subsequent SS available. ER, PR, and Her2 IHC studies were done on all samples and results were compared. ER results on formalin‐fixed CB samples showed excellent correlation with SS (correlation coefficient cc = 0.82). While there was minimal improvement in PR results (cc = 0.433), Her2 detection did not improve by formalin fixation (cc = 0.439). Formalin fixation for CB preparations does not significantly improve the already good detection of ER positive breast tumors. The concordance rate in PR and IHC results between formalin‐fixed CB and SS samples showed improvement as compared with the alcohol‐fixed CB results. However, there was no improvement in detection of Her2 overexpression by using formalin fixation on cytology specimens. Diagn. Cytopathol. 2013. © 2012 Wiley Periodicals, Inc.