Oestrogen and Progesterone Receptors
(ER/PR)
Key facts
- Presence of ER/PR in breast tumour cells is considered a good
prognostic feature
- ER/PR-positive tumours generally respond better to hormone
therapies
The value of morphological assessment can be enhanced by the use
of a range of tissue based assays performed in our Reference
Laboratory. These provide further information to aid in assessing
prognosis, and perhaps more importantly in assessing adjuvant
treatment suitability. One such test, recommended by NICE guidance,
and which we are already providing to the NHS and private
healthcare sectors, is the ER/PR test.
Oestrogen and progesterone receptor status is determined
immunohistochemically. While providing some prognostic information,
these paired tests are also used routinely in a treatment decision
role, to determine suitability for hormone therapies such as
Tamoxifen or aromatase inhibitors. Source BioScience Healthcare
utilises our own in-house, standardised and validated tests, as
well as commercially available assays for both Oestrogen and
Progesterone receptor, providing a comprehensive and analytically
robust service to the clinician.
Evaluation
Immunostaining for ER and PR is evaluated visually by
pathologists and laboratory scientists, and the result presented in
the form requested by the client, as percentage positive cells,
H-score or Allred Quickscore.
The H-score is a semi-quantitative system for assessing the
intensity and distribution of positive staining with a range
between 0 and 300. A score of 300 is achieved when 100% of the
tumour cells show the highest level of intensity (scored as 0-3). A
score above 10 is considered positive. A negative result for ER/PR
is considered a poor prognostic sign, while a positive is an
indicator for tamoxifen or other hormonal therapies.
The Quick score is a similar system with a range between 0 and
8. Scores of over 2 are considered positive.
An example of a breast carcinoma showing strong nuclear
expression of the oestrogen receptor (ER)