Chemotherapy naive breast cancer: a correlation study between BD Cytorich™ Red cell blocks and formalin- fixed paraffinembedded tissue blocks

[摘要] Background: The ever increasing burden of breast cancer, the most common cancer amongwomen, demands a diagnostic test that is rapid, reliable, informative and cost-effective;particularly in countries with limited financial and medical resources. FNAB cytology andcell block combination has gained worldwide utility and has been described to be accurateand reliable.Aim: Henceforth the aim of this study was to retrospectively correlate the expression ofprognostication markers, namely, estrogen receptor (ER), progesterone receptor (PR) andhuman epidermal growth factor receptor 2 (HER2) performed on cell blocks (using the BDCytorichTM Red method) and formalin-fixed, paraffin-embedded cell blocks (FFPET) inchemotherapy naive breast carcinomas, by immunochemistry (immunocytochemistry andimmunohistochemistry respectively) and to perform fluorescence in-situ hybridization (FISH)testing for over- expression of the HER2 gene.Methods: Between 2013 and 2016, 132 cases of primary breast carcinoma were identifiedthat had both cytology (including Cytorich™ Red cell blocks) and histology specimens thatwere both chemotherapy naive. Immunostaining for ER, PR and HER2 was performed. Thestaining was scored according to the Allred scoring system for histology specimen and thissystem was slightly adapted for cytology specimens, which also took the American Society ofClinical Oncology (ASCO)/College of American Pathologists (CAP) guidelines into account.FISH for HER2 over-expression was performed. The grade of the carcinoma was alsoanalysed on both the cytology specimens (using the Robertson's grading system) and thehistology specimens (using the Modified Elston & Ellis system).Results: ER and PR performed on cell blocks had good correlation with FFPET with 91%and 85% sensitivity, respectively. HER2 on cell blocks had an agreement of 88% withFFPET. 87.88% of cell blocks had more than a 100 tumour cells present on H&E sectionsand cytological grading had an agreement of 41.41% with histological grading.Conclusion: The cell block technique continues to play a vital role in the diagnosis ofprimary, recurrent and metastatic breast carcinoma, allowing assessment of prognosis andprediction of response to therapy.

[发布机构] Stellenbosch University