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Estrogen Receptor Expression in Benign Breast Ductal Cells Obtained from Random Periareolar Fine Needle Aspiration Correlates with Menopausal Status and Cytomorphology Index Score

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Abstract

Introduction

Estrogen receptor (ER) expression in breast epithelial cells has potential as a risk marker for development of breast cancer and as a response marker for preventive interventions.

Aim

The purpose of this study was to determine if ER expression in benign cytologic specimens acquired by random periareolar fine needle aspiration (RPFNA) increases with morphologic abnormality as has been reported for histologic preparations.

Methods

ER expression was assessed in 122 women at high risk for development of breast cancer who had RPFNA hyperplasia ± atypia and were being screened for entry into one of two chemoprevention trials. ER was assessed using antigen retrieval at 90°C for 2 min and the DAKO ER monoclonal antibody (Clone number 1D5). The proportion of cells with definitive staining at each intensity level (0–4) was recorded as a percentage of the total cells counted, to give a weighted intensity score (IS).

Results

Of 122 women, 65% exhibited hyperplasia and 35% exhibited hyperplasia with atypia in their RPFNA specimens. A majority (66%) of subjects had at least 10% of ductal cells exhibiting nuclear staining for ER. Median percent of cells with ≥1+ staining was 20% and the median ER IS was 0.23. There was a strong correlation between ER IS and percentage of ER positive cells (R2 = 0.88). By univariate analysis ER IS was statistically significantly higher in women older than median age of 48 years (P = 0.025), in postmenopausal women on HRT (P < 0.017), and in women with a Masood cytomorphology index score of ≥14 (P = 0.005). On multivariable analysis, ER IS was significantly associated with postmenopausal status (P = 0.038) and cytomorphology as measured by Masood score (P = 0.043).

Conclusion

ER can be readily measured in cytologic specimens obtained by RPFNA with the use of antigen retrieval method. Further, ER expression in cytologic specimens is influenced by postmenopausal status and morphologic abnormality.

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Acknowledgements

This study was funded in part by contract NO1-CN-15135 from the Chemoprevention Branch, Cancer Prevention Research Program-Cancer Control, Division of Cancer Prevention of the National Cancer Institute, NIH; and by grant BCTR0100732 from the Susan G. Komen Breast Cancer Research Foundation.

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Authors and Affiliations

  1. Department of Internal Medicine, Division of Hematology/Oncology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA

    Priyanka Sharma, Chezna Warner, Trina Metheny, Qiao Xue & Carol J. Fabian

  2. Department of Radiation Oncology, University of Kansas Medical Center, Kansas City, KS, USA

    Bruce F. Kimler

  3. Yale University, New Haven, CT, USA

    Carola M. Zalles

Authors
  1. Priyanka Sharma
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  2. Bruce F. Kimler
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  3. Chezna Warner
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  4. Trina Metheny
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  5. Qiao Xue
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  6. Carola M. Zalles
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  7. Carol J. Fabian
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Correspondence to Carol J. Fabian.

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Sharma, P., Kimler, B.F., Warner, C. et al. Estrogen Receptor Expression in Benign Breast Ductal Cells Obtained from Random Periareolar Fine Needle Aspiration Correlates with Menopausal Status and Cytomorphology Index Score. Breast Cancer Res Treat 100, 71–76 (2006). https://doi.org/10.1007/s10549-006-9234-8

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  • DOI: https://doi.org/10.1007/s10549-006-9234-8

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