[Histonet] RE: ER/PR results tracking

Cartun, Richard Richard.Cartun <@t> hhchealth.org
Tue Sep 24 16:04:52 CDT 2013

Hi Clare:

Unfortunately, I have to do it manually using an Excel spreadsheet that I created.  For every case we test (invasive, DCIS, and metastatic), I keep track of the specimen number, block designation, the time the tissue is placed in formalin, ER IHC result, PR IHC result, HER2 IHC result, HER2 FISH (if we do it and "we don't do many"), Oncotype DX result (if performed), and comments such as "repeat on excisional tumor", "S/P neoadjuvant chemotherapy (with or without Herceptin), "biopsy immunoprofile confirmed", etc.  It's a lot of work, but I have exceptionally good data going back to 2011.  For example, my positive rates for invasive carcinoma (114 cases) during the period from January-March, 2013 are:

ER - 88.6%
PR - 70.2%
HER2 - 15.8%

I just gave talks on this at the ASCP and NSH meetings.


Richard W. Cartun, MS, PhD
Director, Histology & Immunopathology
Director, Biospecimen Collection Programs
Assistant Director, Anatomic Pathology
Hartford Hospital
80 Seymour Street
Hartford, CT  06102
(860) 545-1596 Office
(860) 545-2204 Fax
richard.cartun <@t> hhchealth.org

From: histonet-bounces <@t> lists.utsouthwestern.edu [histonet-bounces <@t> lists.utsouthwestern.edu] on behalf of Clare Thornton [CThornton <@t> dahlchase.com]
Sent: Tuesday, September 24, 2013 2:40 PM
To: histonet <@t> lists.utsouthwestern.edu
Subject: [Histonet] ER/PR results tracking

How is everyone tracking their ER/PR results to comply with the following:


Annual Result Comparison

Phase I

For immunohistochemical and FISH/ISH tests that provide independent predictive information, the laboratory at least annually compares its patient results with published benchmarks, and evaluates interobserver variability among the pathologists in the laboratory.

NOTE: Individuals interpreting the assay must also have their concordance compared with each other and this concordance should also be at least 95%.

With specific reference to estrogen and progesterone receptor studies: in general, the overall proportion of ER-negative breast cancers (invasive and DCIS) should not exceed 30%. The average is somewhat lower in postmenopausal than premenopausal women (approximately 20% vs. 35%). The average is considerably lower in well-differentiated carcinomas (<10%) and certain special types of invasive carcinomas (<10% in lobular, tubular, and mucinous types). The proportion of PgR-negative cases is 10-15% higher than for ER in each of these settings. Investigation is warranted if the proportion of negative cases is significantly higher in any of these settings.

Our LIS doesn't have an easy way of compiling these results.  Basically, we are stuck with searching all cases with ER/PR done and manually reading and recording results.  Does anyone have a good shortcut or idea of how to compile these results when your LIS doesn't keep track of the results for you?

Thanks in advance!

Clare J. Thornton, HTL(ASCP)QIHC
Assistant Histology Supervisor
Dahl-Chase Diagnostic Services
417 State Street, Suite 540
Bangor, ME 04401
cthornton <@t> dahlchase.com

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