Clinico-pathology of newly diagnosed breast cancer with expression of ER, PR, and HER/2neu in cell blocks: An observational prospective study

Abstract

Background: Breast cancer is a worldwide problem, and early positive diagnosis is critical for establishing the optimal therapeutic strategy. Following a preliminary diagnosis, fine-needle aspirate cytology (FNAC) may be used to obtain cells for immunohistochemical (IHC) analysis and histopathological examination. This study aimed to assess the FNAC method combined with embedding samples in paraffin blocks (cell blocks) and comparing this with core biopsies (tissue blocks). Methods: This observational, prospective study was performed at our hospital and involved 50 female participants who presented with breast masses and were subsequently evaluated for high-risk status by FNAC and IHC. Tests for estrogen receptor (ER), progesterone receptor (PR), and human EGF receptor 2 (HER2/neu) were performed and the sensitivity, specificity, and discrepancy rates between methodologies were calculated using correlation analysis and agreement tests. Results: The correlation analysis between immuno-staining of sections from cell blocks and histopathological examination of sections from tumor-tissue blocks revealed a high concordance for HR and HER2/neu. Conclusion: IHC of cell-block sections was found to be better for the determination of HR status and HER2/neu levels. It is very important to obtain high-quality cell blocks with strict quality control for their clarification.