Cancer Diagnosis Program | Biorepositories and Biospecimen Research Branch

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The effect of prolonged cold ischemia time on estrogen receptor immunohistochemistry in breast cancer.

Author(s): Li X, Deavers MT, Guo M, Liu P, Gong Y, Albarracin CT, Middleton LP, Huo L

Publication: Mod Pathol, 2013, Vol. 26, Page 71-8

PubMed ID: 22899286 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   This study compared ER staining in 97 matched breast cancer biopsy and resection specimens to examine the effects of cold ischemia time on surgically resected specimens. Cold ischemia times for the resection specimens ranged from 64 to 357 min and included ~10 min of warm ischemia time. Specimens were fixed for 6-78h with the majority (91 specimens) falling within the 6-72 h window. ER immunohistochemical staining was performed on 4 mm sections from each biopsy and resected specimen. Each slide was independently scored by three observers and grouped into three categories based on staining intensity and percentage: ≥10%, positive; 1– 9%, low positive; <1%, negative. Matched specimens were also divided into three groups (no change, decreased or increased ER staining) using a difference of 25% in ER staining between biopsy and resected specimens as the cutoff.

   Summary of Findings:

   A difference in ER staining between the biopsy and resected specimen greater than 5% resulted in a change in category for only five of the 97 cases, demonstrating a 95% concordance (specimens with no staining in the biopsy and 1-5% weak staining in the resection were considered concordant). Differences in percentage of ER staining between biopsy and resection specimens were not associated with cold ischemia time in either the increased or decreased groups or when both groups (increased and decreased) were compared to those with no change in staining intensity. A minimal but not statistically significant difference was found in the pairwise comparison between the “no change” and the “decreased” groups in association with cold ischemia times greater than 2 h (P = 0.03). Of the three cases with significant differences in ER staining, two cases demonstrated weak staining (10% and 7%) in the biopsy compared to strong staining in the resected specimen (70% and 75%, respectively) and one case demonstrated strong staining (80%) in the biopsy compared to weak staining (30%) in the resected specimen. In addition, no significant correlation in changes of ER staining of biopsy and resected specimens was observed between patients who had or had not received neoadjuvant chemotherapy.

   Biospecimens

   • Tissue - Breast

   Preservative Types

   • Formalin

   Diagnoses:

   • Neoplastic - Carcinoma

   Platform:

   Analyte	Technology Platform
   Protein	Immunohistochemistry

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Preaquisition	Other drugs	None Chemotherapy
   Biospecimen Acquisition	Cold ischemia time	<120 min 121-180 min 181 - 240 min >241 min
   Biospecimen Acquisition	Method of tissue acquisition	Biopsy Surgical resection

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