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Hormone Receptor Expression in Invasive Breast Cancer Among Korean Women and Comparison of 3 Antiestrogen Receptor Antibodies: A Multi-institutional Retrospective Study Using Tissue Microarrays

Bae, Young Kyung MD, PhD; Gong, Gyungyub MD, PhD; Kang, Jun MD, PhD; Lee, Ahwon MD, PhD; Cho, Eun Yoon MD, PhD; Lee, Ji Shin MD, PhD; Suh, Kwang-Sun MD, PhD; Lee, Dong Wha MD, PhD

The American Journal of Surgical Pathology: December 2012 - Volume 36 - Issue 12 - p 1817–1825
doi: 10.1097/PAS.0b013e318267b012
Original Articles

Estrogen receptor (ER) and progesterone receptor (PR) are prognostic markers of breast cancer and predictive markers of response to endocrine therapy. To determine rates of ER and PR expression in invasive breast carcinoma among Korean women, the Breast Pathology Study Group of the Korean Society of Pathologists collected 1198 specimens of invasive breast carcinoma from 6 university hospitals. Immunohistochemical analysis was carried out using 1 antibody against PR and 3 antibodies against ER (1D5, 6F11, and SP1). Specimens were evaluated using the semiquantitative Allred score (scores >2 were considered positive). A total of 1077 cases were interpretable for all 3 anti-ER antibodies. ER expression was positive in 68.5% of cases using SP1, in 59.6% using 1D5, and in 58.9% using 6F11. Of 1073 interpretable cases, PR expression was positive in 51.7% of cases. The frequency distribution of Allred scores revealed a bimodal pattern (complete absence of staining or staining in most cells) for both ER and PR. Patients with discordant results for 2 different ER antibodies showed a median overall survival (between that of double-positive cancer and that of double-negative cancer). Our results showed that the rate of hormone receptor expression in breast carcinomas among Korean patients did not differ from that of western patients. In addition, SP1 was the most sensitive antibody for identifying ER expression in tumors. However, further evaluation is needed to determine which antibody is the best for selecting patients with discordant results who are likely to respond to endocrine therapy.

*Department of Pathology, Yeungnam University College of Medicine, Daegu

Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center

§Department of Pathology, The Catholic University of Korea College of Medicine

Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine

**Department of Pathology, Soonchunhyang University Hospital, Seoul

Department of Pathology, Haeundae Paik Hospital, Inje University College of Medicine, Busan

Department of Pathology, Chonnam National University School of Medicine, Gwangju

#Department of Pathology, Chungnam National University College of Medicine, Daejeon, Korea

Conflicts of Interest and Source of Funding: Supported by a research grant from the Asan Institute for Life Sciences (2010-169). The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Correspondence: Gyungyub Gong, MD, PhD, Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul 138-736, Korea (e-mail: gygong@amc.seoul.kr).

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.