Computer-assisted immunocytochemical determination of breast cancer steroid receptors on cytological smears of excised surgical specimens compared with frozen sections

Background: Due to the widespread use of fine needle aspirate biopsy the pr actice of determining estrogen (ER) and progesterone (PR) receptors in brea st carcinoma from cytological smears (CS) is becoming very common, The aim of this study was to determine concordance between ER and PR assessed by im munocytochemical assay (ICA) on CS and FS both evaluated by image analysis since we have found no data in literature on this. Methods: 104 breast carc inoma cases were selected. For all cases ER and PR determination was perfor med on CS, obtained by light scraping of the freshly cut surface of the exc ised surgical tumors at the time of frozen section diagnosis, and FS using the same monoclonal antibodies. Computer-assisted image analysis was perfor med in all cases using CAS 200. Results were expressed as percent positive area of neoplastic nuclei compared with total nuclear area of the examined neoplastic cells. Results: Good correlation was demonstrated between percen t positive nuclear neoplastic area by ER-ICA on CS and FS (r = 0.759; P < 0 .0001). Concordance of results was 90.19% (P < 0.001). Good correlation was also demonstrated between percent positive nuclear neoplastic area by PR-I CA in CS and FS (r = 0.889; P < 0.0001). Concordance of results was 97.02% (P < 0.0001). Conclusions: Our data suggest that ICA on CS with automated i mage analysis is efficient in evaluating ER and PR content in human breast cancer, especially when CS is the only method pathologists have to evaluate receptor status e.g. in advanced breast cancer cases when neoadjuvant ther apy is necessary before surgery or when surgery is impossible. Cytometry (C omm. Clin. Cytometry) 38:301-305, 1999. (C) 1999 Wiley-Liss, Inc.