Estrogen and Progesterone Receptor Testing in Breast Cancer: ASCO/CAP Guideline Update.

By K. Allison, M. Hammond, Mitchell Dowsett, Shannon E McKernin, Lisa A. Carey, P. Fitzgibbons, D. Hayes, S. Lakhani, M. Chávez-MacGregor, J. Perlmutter and 11 more. Journal of Clinical Oncology, 2020

1,200 citations recorded by the source corpus.

PURPOSE To update key recommendations of the American Society of Clinical Oncology/College of American Pathologists estrogen (ER) and progesterone receptor (PgR) testing in breast cancer guideline. METHODS A multidisciplinary international Expert Panel was convened to update the clinical practice guideline recommendations informed by a systematic review of the medical literature. RECOMMENDATIONS The Expert Panel continues to recommend ER testing of invasive breast cancers by validated immunohistochemistry as the standard for predicting which patients may benefit from endocrine therapy, and no other assays are recommended for this purpose. Breast cancer samples with 1% to 100% of tumor nuclei positive should be interpreted as ER positive. However, the Expert Panel acknowledges that there are limited data on endocrine therapy benefit for cancers with 1% to 10% of cells staining ER positive. Samples with these results should be reported using a new reporting category, ER Low Positive, with a recommended comment. A sample is considered ER negative if < 1% or 0% of tumor cell nuclei are immunoreactive. Additional strategies recommended to promote optimal performance, interpretation, and reporting of cases with an initial low to no ER staining result include establishing a laboratory-specific standard operating procedure describing additional steps used by the laboratory to confirm/adjudicate results. The status of controls should be reported for cases with 0% to 10% staining. Similar principles apply to PgR testing, which is used primarily for prognostic purposes in the setting of an ER-positive cancer. Testing of ductal carcinoma in situ (DCIS) for ER is recommended to determine potential benefit of endocrine therapies to reduce risk of future breast cancer, while testing DCIS for PgR is considered optional. Additional information can be found at www.asco.org/breast-cancer-guidelines.

Subfields: Cancer Research, Genetics, Pathology and Forensic Medicine

View Paper: https://www.semanticscholar.org/paper/466d54f0c83ba079ec85f5814092dec7d06f4c7a

How researchers see this paper

The researchers whose trusted networks rank it highest, strongest advocate first. Every researcher gets a different order.

In Cancer Research

1. Mitchell Dowsett
2. S. Leung
3. Torsten O. Nielsen
4. Balázs Győrffy

In Genetics

1. Mitchell Dowsett
2. Lisa M. McShane

In Pathology and Forensic Medicine

1. S. Leung
2. Torsten O. Nielsen

Citations in the corpus

• Assessment of Ki67 in Breast Cancer: Updated Recommendations From the International Ki67 in Breast Cancer Working Group (2020, background): “Consensus observations and recommendations are: 1) as for estrogen receptor and HER2 testing, preanalytical handling considerations are critical; 2) a standardized visual scoring method has been established and is recommended for adoption; 3) participation in and evaluation of quality assurance and ”
• 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) (2020, neutral): “Recently, the ASCO-College of American Pathologists (CAP) guidelines acknowledged that patients with tumours between 1% and 10% of ER staining represent a new reporting category, stipulating the lack of data concerning benefit from ET and the proximity to ER-negative breast cancer of this patient gr”