Assessment of estrogen receptor low positive status in breast cancer: Implications for pathologists and oncologists.


Journal

Histology and histopathology
ISSN: 1699-5848
Titre abrégé: Histol Histopathol
Pays: Spain
ID NLM: 8609357

Informations de publication

Date de publication:
Dec 2021
Historique:
pubmed: 30 9 2021
medline: 1 4 2022
entrez: 29 9 2021
Statut: ppublish

Résumé

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 ER-negative 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.

Identifiants

pubmed: 34585734
pii: HH-18-376
doi: 10.14670/HH-18-376
doi:

Substances chimiques

Receptors, Estrogen 0
Receptor, ErbB-2 EC 2.7.10.1

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1235-1245

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Auteurs

Nicola Fusco (N)

Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy. nicola.fusco@unimi.it.
Department of Oncology and Haemato-Oncology, University of Milano, Milan, Italy.

Moira Ragazzi (M)

Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Pathology Unit, Reggio Emilia, Italy.

Elham Sajjadi (E)

Department of Oncology and Haemato-Oncology, University of Milano, Milan, Italy.
Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy.

Konstantinos Venetis (K)

Department of Oncology and Haemato-Oncology, University of Milano, Milan, Italy.
Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy.

Roberto Piciotti (R)

Department of Oncology and Haemato-Oncology, University of Milano, Milan, Italy.
Division of Pathology, IEO, European Institute of Oncology IRCCS, Milan, Italy.

Stefania Morganti (S)

Department of Oncology and Haemato-Oncology, University of Milano, Milan, Italy.
Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy.

Giacomo Santandrea (G)

Clinical and Experimental Medicine Ph.D. Program, University of Modena and Reggio Emilia, Modena, Italy.

Giuseppe Nicolò Fanelli (GN)

Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.

Luca Despini (L)

Breast Surgery Unit, Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy.

Marco Invernizzi (M)

Physical and Rehabilitation Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy.
Physical and Rehabilitation Medicine Unit, University Hospital "Maggiore della Caritá", Novara, Italy.

Bruna Cerbelli (B)

Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy.

Cristian Scatena (C)

Division of Pathology, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Department of Laboratory Medicine, Pisa University Hospital, Anatomia Patologica 1 Universitaria, Pisa, Italy.

Carmen Criscitiello (C)

Department of Oncology and Haemato-Oncology, University of Milano, Milan, Italy.
Division of Early Drug Development for Innovative Therapies, IEO, European Institute of Oncology IRCCS, Milan, Italy.

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