Template:Immunohistochemistry evaluation of invasive breast cancer: Difference between revisions
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<br>- Not be located in stroma. | <br>- Not be located in stroma. | ||
<br>- Be at least half within the field of view. | <br>- Be at least half within the field of view. | ||
<br>- Be large enough.]] | <br>- Be large enough.<br>Otherwise, even weakly positive nuclei count as positive.]] | ||
Ki-67 index is mainly relevant in those with stage T1-T2, N0-N1, to determine if chemotherapy is needed (if Ki67 is >30% rather than <5%).<ref name="DowsettNielsen2011">{{cite journal|last1=Dowsett|first1=M.|last2=Nielsen|first2=T. O.|last3=A'Hern|first3=R.|last4=Bartlett|first4=J.|last5=Coombes|first5=R. C.|last6=Cuzick|first6=J.|last7=Ellis|first7=M.|last8=Henry|first8=N. L.|last9=Hugh|first9=J. C.|last10=Lively|first10=T.|last11=McShane|first11=L.|last12=Paik|first12=S.|last13=Penault-Llorca|first13=F.|last14=Prudkin|first14=L.|last15=Regan|first15=M.|last16=Salter|first16=J.|last17=Sotiriou|first17=C.|last18=Smith|first18=I. E.|last19=Viale|first19=G.|last20=Zujewski|first20=J. A.|last21=Hayes|first21=D. F.|title=Assessment of Ki67 in Breast Cancer: Recommendations from the International Ki67 in Breast Cancer Working Group|journal=JNCI Journal of the National Cancer Institute|volume=103|issue=22|year=2011|pages=1656–1664|issn=0027-8874|doi=10.1093/jnci/djr393}}</ref> | Ki-67 index is mainly relevant in those with stage T1-T2, N0-N1, to determine if chemotherapy is needed (if Ki67 is >30% rather than <5%).<ref name="DowsettNielsen2011">{{cite journal|last1=Dowsett|first1=M.|last2=Nielsen|first2=T. O.|last3=A'Hern|first3=R.|last4=Bartlett|first4=J.|last5=Coombes|first5=R. C.|last6=Cuzick|first6=J.|last7=Ellis|first7=M.|last8=Henry|first8=N. L.|last9=Hugh|first9=J. C.|last10=Lively|first10=T.|last11=McShane|first11=L.|last12=Paik|first12=S.|last13=Penault-Llorca|first13=F.|last14=Prudkin|first14=L.|last15=Regan|first15=M.|last16=Salter|first16=J.|last17=Sotiriou|first17=C.|last18=Smith|first18=I. E.|last19=Viale|first19=G.|last20=Zujewski|first20=J. A.|last21=Hayes|first21=D. F.|title=Assessment of Ki67 in Breast Cancer: Recommendations from the International Ki67 in Breast Cancer Working Group|journal=JNCI Journal of the National Cancer Institute|volume=103|issue=22|year=2011|pages=1656–1664|issn=0027-8874|doi=10.1093/jnci/djr393}}</ref> | ||
Revision as of 21:12, 6 April 2022
Immunohistochemistry
Ki-67 index
- Not be located in stroma.
- Be at least half within the field of view.
- Be large enough.
Otherwise, even weakly positive nuclei count as positive.
Ki-67 index is mainly relevant in those with stage T1-T2, N0-N1, to determine if chemotherapy is needed (if Ki67 is >30% rather than <5%).[1]
Ki-67 index is most feasibly quantified by a hot spot method,[notes 1] Hot spots are areas in which Ki-67 staining is particularly higher relative to the adjacent tumor areas.[2] Usually, the invasive edge of a tumor is a hot spot.[2] When a tumor had several hot spots, the “hottest” spot is selected.[2] Aim to count at least 500 cells in each case, but this is not always possible in cases with low tumor cell density and small tumor size.[2] Also aim to include at least three high-power (×40 objective) fields. Count a nucleus as “positive” if there is any definite brown staining in the nucleus of an invasive breast cancer cell, above the surrounding background in the cytoplasm and extracellular matrix.[3] If a comparisons must be made between core biopsies and sections from an excision, evaluation of the latter should be across the whole tumor.[1] Only nuclear staining counts. Staining intensity of a positive nucleus is not relevant.[1]
HER2/neu
| Score[4] | Status[4] |
|---|---|
| 0 to 1+ | HER2 negative (not present) |
| 2+ | Borderline |
| 3+ | HER2 positive |
-
HER2/neu staining is seen as a cell membrane with continuous brown color.
Notes
- ↑ Besides from a hot spot method of Ki67 counting, there is also a IKWG global average method which is more comprehensive. However, the inter-observer difference between the hot spot method and the 'IKWG global average is not statistically significant, and has not shown any significant difference in clinical outcome (theoretically, the area of highest Ki-67 proliferative index is probably most likely to correlate with malignant transformation and risk of metastasis, making the hot spot both more straightforward and clinically relevant than a global average).
- Reference and instructions for the IKWG global average method: Dowsett, M.; Nielsen, T. O.; A'Hern, R.; Bartlett, J.; Coombes, R. C.; Cuzick, J.; Ellis, M.; Henry, N. L.; et al. (2011). "Assessment of Ki67 in Breast Cancer: Recommendations from the International Ki67 in Breast Cancer Working Group ". JNCI Journal of the National Cancer Institute 103 (22): 1656–1664. doi:. ISSN 0027-8874.
Main page
References
- ↑ 1.0 1.1 1.2 Dowsett, M.; Nielsen, T. O.; A'Hern, R.; Bartlett, J.; Coombes, R. C.; Cuzick, J.; Ellis, M.; Henry, N. L.; et al. (2011). "Assessment of Ki67 in Breast Cancer: Recommendations from the International Ki67 in Breast Cancer Working Group ". JNCI Journal of the National Cancer Institute 103 (22): 1656–1664. doi:. ISSN 0027-8874.
- ↑ 2.0 2.1 2.2 2.3 Coleman, William B.; Jang, Min Hye; Kim, Hyun Jung; Chung, Yul Ri; Lee, Yangkyu; Park, So Yeon (2017). "A comparison of Ki-67 counting methods in luminal Breast Cancer: The Average Method vs. the Hot Spot Method ". PLOS ONE 12 (2): e0172031. doi:. ISSN 1932-6203.
- ↑ . Ki67-QC international working group: whole section scoring protocol (global method). International Ki67 in Breast Cancer Working Group (2018-11-29).
- ↑ 4.0 4.1 . IHC Tests (ImmunoHistoChemistry). Breastcancer.org. Retrieved on 2019-10-04. Last modified on October 23, 2015
Image sources