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Consistency of staining and reporting of oestrogen receptor immunocytochemistry within the European Union—an inter-laboratory study

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Abstract

To assess the variability of oestrogen receptor (ER) testing using immunocytochemistry, centrally stained and unstained slides from breast cancers were circulated to the members of the European Working Group for Breast Screening Pathology, who were asked to report on both slides. The results showed that there was almost complete concordance among readers (kappa=0.95) in ER-negative tumours on the stained slide and excellent concordance among readers (kappa=0.82) on the slides stained in each individual laboratory. Tumours showing strong positivity were reasonably well assessed (kappa=0.57 and 0.4, respectively), but there was less concordance in tumours with moderate and low levels of ER, especially when these were heterogeneous in their staining. Because of the variation, the Working Group recommends that laboratories performing these stains should take part in a external quality assurance scheme for immunocytochemistry, should include a tumour with low ER levels as a weak positive control and should audit the percentage positive tumours in their laboratory against the accepted norms annually. The Quick score method of receptor assessment may also have too many categories for good concordance, and grouping of these into fewer categories may remove some of the variation among laboratories.

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Authors and Affiliations

  1. Department of Histopathology, St. Bartholomew’s Hospital Medical School, West Smithfield, London , EC1A 7BE, United Kingdom

    C. A. Wells

  2. Department of Pathology, Liverpool, United Kingdom

    J. P. Sloane

  3. Cancer Screening Evaluation Unit, Institute of Cancer Research, Sutton Surrey, United Kingdom

    D. Coleman & C. Munt

  4. Department of Pathology, Instituto de Patologia & Imunologia Molecular da Universidade do Porto, Porto, Portugal

    I. Amendoeira

  5. Department of Pathology, Saint Savvas Hospital, Athens, Greece

    N. Apostolikas

  6. Service d’Anatomie Pathologique, Hopital de Hautepierre, Strasbourg, France

    J. P. Bellocq

  7. Department of Human Pathology and Oncology, University of Florence, Italy

    S. Bianchi

  8. Gerhard-Domagk Institut fur Pathologie, Universitat et Munster, Munster, Germany

    W. Boecker

  9. Istituto di Anatomia e Istologia Patologica, Torino, Italy

    G. Bussolati & A. Sapino

  10. Department of Pathology, Clinical Sciences Institute, University College Hospital, Galway, Ireland

    C. E. Connolly

  11. Pathology Department, Mater Hospital, University College, Dublin, Ireland

    P. Dervan

  12. Pathologische Ontleedkunde, University Hospital, Leuven, Belgium

    M. Drijkoningen

  13. Department of Histopathology, City Hospital, Nottingham, United Kingdom

    I. O. Ellis & C. W. Elston

  14. Sezione Anatomia Patologica M. Malpigni, Universita di Bologna, Ospedale Bellaria, Bologna, Italy

    V. Eusebi

  15. CMP Laboratory, Bruxelles, Belgium

    D. Faverly

  16. Haartman Institute, University of Helsinki, Helsinki, Finland

    P. Heikkila & E. Saksela

  17. National Expert & Training Centre for Breast Cancer Screening, Academisch Ziekenhuis Nijmegen, Nijmegen, The Netherlands

    R. Holland

  18. Institut Paoli Calmettes, Marseille, France

    J. Jacquemier

  19. Laboratorio De Histopatologica, Centro Regional De Oncologia De Coimbra, Coimbra, Portugal

    M. Lacerda

  20. Department of Pathology, Hospital de Navarra, Pamplona, Spain

    J. Martinez-Penuela & E. Zozaya

  21. Department of Pathology, Hospital Virgen del Camino, Pamplona, Spain

    C. De Miguel

  22. Department of Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    J. L. Peterse

  23. Center of Laboratory Medicine and Pathology, Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark

    F. Rank

  24. Institute of Pathology, Donauspital, Wien, Austria

    A. Reiner

  25. Institut Curie, Section Medicale et Hospitaliere, Paris, France

    B. Sigal-Zafrani

  26. Department of Clinical Pathology and Cytology, Huddinge University Hospital, Stockholm, Sweden

    M. Sylvan

  27. Centre Médicale Universitaire, Genève, Switzerland

    B. Borisch

  28. Department of Pathology, Bács-Kiskun County Teaching Hospital, Kecskemét, Hungary

    G. Cserni

  29. Department of Pathology, The Breast Unit, HELIOS Medical Centre, Berlin, Germany

    T. Decker

  30. Department of Pathology, Rambam Hospital, Haifa, Israel

    H. Kerner

  31. 2nd Institute of Pathology, Semmelweis University, Budapest, Hungary

    J. Kulka

  32. Institut fur Pathologie der Karl-Franzens Universitat Graz, Graz, Austria

    P. Regitnig

  33. Division d’Anatomie Pathologique, Laboratoire National de Santé, Luxembourg

    A. M. Tanous

  34. Kalmar County Hospital, Kalmar, Sweden

    S. Thorstenson

Authors
  1. C. A. Wells
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  2. J. P. Sloane
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  3. D. Coleman
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  4. C. Munt
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  5. I. Amendoeira
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  6. N. Apostolikas
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  7. J. P. Bellocq
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  8. S. Bianchi
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  9. W. Boecker
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  10. G. Bussolati
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  11. C. E. Connolly
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  12. P. Dervan
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  13. M. Drijkoningen
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  14. I. O. Ellis
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  15. C. W. Elston
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  16. V. Eusebi
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  17. D. Faverly
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  18. P. Heikkila
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  19. R. Holland
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  20. J. Jacquemier
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  21. M. Lacerda
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  22. J. Martinez-Penuela
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  23. C. De Miguel
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  24. J. L. Peterse
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  25. F. Rank
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  26. A. Reiner
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  27. E. Saksela
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  28. B. Sigal-Zafrani
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  29. M. Sylvan
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  30. B. Borisch
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  31. G. Cserni
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  32. T. Decker
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  33. H. Kerner
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  34. J. Kulka
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  35. P. Regitnig
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  36. A. Sapino
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  37. A. M. Tanous
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  38. S. Thorstenson
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  39. E. Zozaya
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Consortia

The European Working Group for Breast Screening Pathology

Corresponding author

Correspondence to C. A. Wells.

Additional information

The European Working Group for Breast Screening Pathology is supported by the European Commission through the European Breast Cancer Network

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The European Working Group for Breast Screening Pathology., Wells, C.A., Sloane, J.P. et al. Consistency of staining and reporting of oestrogen receptor immunocytochemistry within the European Union—an inter-laboratory study. Virchows Arch 445, 119–128 (2004). https://doi.org/10.1007/s00428-004-1063-8

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  • DOI: https://doi.org/10.1007/s00428-004-1063-8

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