[Histonet] ER/PR benchmarks

[Terri Braud]

The ER/PR benchmarks are those published in the notes section of the checklist question.  We use the lowest numbers of the ranges.  We track , patient age, cancer type, tumor grade, and positive or negative results, then just run the numbers. We also add in some extras, such as cases positive for one antibody, and negative for another, just for tracking purposes only. 
For Interobserver variability, at the advice of CAP, we simply allow each pathologist to independently read the CAP ER/PR (PMB) survey and record their answers.  Those are compared with the correct answers and with each other.  They must achieve <10% variability, or be enrolled in performance improvement until they can.
I hope this helps.
Terri

Terri L. Braud, HT(ASCP)
Anatomic Pathology Supervisor
Laboratory
Holy Redeemer Hospital
1648 Huntingdon Pike
Meadowbrook, PA 19046
ph: 215-938-3689
fax: 215-938-3874

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Today's Topics:

   1. CAP ANP.22970 Query (Joanne Clark)


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Date: Mon, 22 Aug 2016 20:05:00 +0000
From: Joanne Clark <jclark at pcnm.com>
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Subject: [Histonet] CAP ANP.22970 Query
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Hi Histonetters, we are wondering what everyone else out there is doing to be compliant with the following requirement?  We do ER and PR by IHC  but dont know what published benchmarks are out there to compare ourselves to.  Also, how do you record interobserver variability amongst the pathologists?  Any insights into this would be appreciated.



ANP.22970 Annual Result Comparison Phase II 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 proportion is somewhat lower in postmenopausal than premenopausal women (approximately 20% vs. 35%). The proportion 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-negative in each of these settings. Investigation is warranted if the proportion of negative cases is significantly lower in any of these settings.

Joanne Clark, HT
Director of Histology
Pathology Consultants of New Mexico
Roswell, New Mexico




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