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Semi-quantitative scoring of potentially predictive markers for endocrine treatment of breast cancer: a comparison between whole sections and tissue microarrays
  1. Katrine L Henriksen1,
  2. Birgitte B Rasmussen2,
  3. Anne E Lykkesfeldt1,
  4. Susann Møller3,
  5. Bent Ejlertsen4,
  6. Henning T Mouridsen3,4
  1. 1Department of Tumor Endocrinology, Institute of Cancer Biology, Danish Cancer Society, Copenhagen Ø, Denmark
  2. 2Department of Pathology, Roskilde County Hospital, Roskilde, Denmark
  3. 3Danish Breast Cancer Cooperative Group, Rigshospitalet, Copenhagen Ø, Denmark
  4. 4Department of Oncology, Rigshospitalet, Copenhagen Ø, Denmark
  1. Correspondence to:
    Dr B B Rasmussen
    Department of Pathology, Nordsjaellands Hospital, Hilleroed, Helsevej 2, DK-3400 Hilleroed, Denmark; bbr{at}


Aim: To assess whether immunohistochemically stained tissue microarrays (TMA) of 2 mm cores from paraffin embedded tumour tissue may replace whole sections in semi-quantitative evaluation of selected potential markers for endocrine treatment.

Methods: Whole sections and 2 mm cores on TMA were used for immunohistochemical staining of potential markers for endocrine treatment. The Allred scoring system was used for the markers with nuclear localisation: the oestrogen receptor, the progesterone receptor, p27 and the oestrogen receptor co-regulator amplified in breast cancer 1 (AIB1). The Allred scoring system was also used for the non-nuclear markers Bcl-2, pS2 and cyclooxygenase 2 (COX-2); the membrane receptors HER-2, insulin-like growth factor I receptor (IGF-IR) and epidermal growth factor receptor were quantified according to the guidelines for the Herceptest.

Results: The data and statistical analyses showed that the semi-quantitative evaluation of oestrogen receptor, progesterone receptor, AIB1, COX-2, HER-2 and IGF-IR on TMA blocks was comparable with analysis on whole sections.

Conclusions: This study shows that semi-quantitative scoring of 2 mm cores on TMA is feasible for several potential markers for endocrine therapy. Considering the small size of many breast tumours, the speed and cost-effectiveness of immunohistochemistry on TMA compared with whole sections, and the importance of the expression level of the proteins, semi-quantitative scoring on TMA has great potential in both retrospective and prospective studies aiming at improving the prediction of response to endocrine treatment.

  • AIB1, oestrogen receptor co-regulator amplified in breast cancer 1
  • COX-2, cyclooxygenase 2
  • EGFR, epidermal growth factor receptor
  • IHC, immunohistochemistry
  • IGF-IR, insulin-like growth factor I receptor
  • TMA, tissue microarray

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  • Published Online First: 14 June 2006

  • Competing interests: None.

  • Ethics approval: The local science ethics committees for Copenhagen and Frederiksberg counties and the Danish Data Protection Agency have approved the research protocol.