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Fractionated evaluation of immunohistochemical hormone receptor expression enhances prognostic prediction in breast cancer patients treated with tamoxifen as adjuvant therapy

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Abstract

Objective

To compare the prognostic prediction between dichotomized and fractionated evaluations of hormone receptor expressions.

Methods

Patients with stages I–III breast cancers, who received adjuvant tamoxifen, were enrolled. The expression of estrogen receptor (ER) and progesterone receptor (PR) was evaluated by immunohistochemistry (IHC). A fractionated score (F score), the percentage of positive-staining nuclei (0=none, 1=1%–10%, 2=11%–30%, 3=31%–50%, 4=51%–70%, and 5=71%–100%), was assigned to each case. The dichotomized scoring method defines an F score >1 as positive. The prognostic values of both scores were compared by multiple Cox’s proportional hazard models of disease-free survival (DFS) and overall survival (OS).

Results

Four hundred and sixteen patients with a median follow-up of 78.0 months were included. F scores for ER and PR correlated directly with DFS and OS. Although both the dichotomized and fractionated ER and PR scores were significantly associated with DFS and OS in univariate analyses, only fractionated ER and PR scores remained as independent prognostic factors of DFS and OS in the final multiple Cox’s proportional hazard models.

Conclusion

Fractionated IHC hormone receptor expression evaluation enhances the prognostic prediction compared with a dichotomized assessment.

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Authors and Affiliations

  1. Department of Oncology, National Taiwan University Hospital, Taiwan, Taipei, 10016, Taiwan

    Ching-hung Lin, Yen-shen Lu, Sung-hsin Kuo & Ann-lii Cheng

  2. Department of Pathology, National Taiwan University Hospital, Taiwan, Taipei, 10016, Taiwan

    Huang-chun Lien

  3. National Center of Excellence for General Clinical Trial and Research, National Taiwan University Hospital, Taiwan, Taipei, 10016, Taiwan

    Fu-chang Hu & Ling-chu Wu

  4. Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, Taiwan, Taipei, 10055, Taiwan

    San-lin You

  5. Department of Surgery, National Taiwan University Hospital, Taiwan, Taipei, 10016, Taiwan

    King-jen Chang & Chiun-sheng Huang

Authors
  1. Ching-hung Lin
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  2. Huang-chun Lien
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  3. Fu-chang Hu
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  4. Yen-shen Lu
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  5. Sung-hsin Kuo
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  6. Ling-chu Wu
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  7. San-lin You
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  8. Ann-lii Cheng
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  9. King-jen Chang
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  10. Chiun-sheng Huang
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Corresponding author

Correspondence to Chiun-sheng Huang.

Additional information

Project supported by the National Center of Excellence for Clinical Trial and Research of National Taiwan University Hospital (No. DOH97-TD-B-111-001), Taiwan, Taipei

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Lin, Ch., Lien, Hc., Hu, Fc. et al. Fractionated evaluation of immunohistochemical hormone receptor expression enhances prognostic prediction in breast cancer patients treated with tamoxifen as adjuvant therapy. J. Zhejiang Univ. Sci. B 11, 1–9 (2010). https://doi.org/10.1631/jzus.B0900295

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  • DOI: https://doi.org/10.1631/jzus.B0900295

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