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Immunohistochemical Markers as a Surrogate Method for Differentiation of Luminal Subtypes of Breast Cancer and Their Prognostic Significance

Published:September 27, 2020DOI:https://doi.org/10.1016/j.clbc.2020.07.016
      We read with interest the article focusing on use of immunohistochemical markers for classification of hormone receptor-positive breast cancer into luminal A and luminal B subtypes, published in your esteemed journal.
      • Sali A.P.
      • Sharma N.
      • Verma A.
      • et al.
      Identification of luminal subtypes of breast carcinoma using surrogate immunohistochemical markers and ascertaining their prognostic relevance.
      The authors have studied the utility of immunohistochemical markers (estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 [HER2], and Ki67) with fluorescence in situ hybridization testing for equivocal HER2 expression on immunohistochemistry (IHC). The classification between luminal A and luminal B subtypes has been based on St Gallen guidelines.
      • Goldhirsch A.
      • Winer E.P.
      • Coates A.S.
      • et al.
      Panel Members
      Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer, 2013.
      The authors have also compared the hot spot and average methods for the assessment for Ki67 labeling index. They found that only 6% of the cases were differently classified between the hot spot and average methods, and they have used the hot spot method for final classification in their study. We would like to complement the authors for this study, which is probably the largest study from an Indian center focusing of this aspect of breast cancer management. There are some comments that we wanted to share with the authors and the readers.
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      References

        • Sali A.P.
        • Sharma N.
        • Verma A.
        • et al.
        Identification of luminal subtypes of breast carcinoma using surrogate immunohistochemical markers and ascertaining their prognostic relevance.
        Clin Breast Cancer. 2020; 20: 382-389
        • Goldhirsch A.
        • Winer E.P.
        • Coates A.S.
        • et al.
        • Panel Members
        Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer, 2013.
        Ann Oncol. 2013; 24: 2206-2223
        • Jang M.H.
        • Kim H.J.
        • Chung Y.R.
        • Lee Y.
        • Park S.Y.
        A comparison of Ki-67 counting methods in luminal breast cancer: the average method vs. the hot spot method.
        PLoS One. 2017; 12: e0172031
        • Robertson S.
        • Acs B.
        • Lippert M.
        • Hartman J.
        Prognostic potential of automated Ki67 evaluation in breast cancer: different hot spot definitions versus true global score.
        Breast Cancer Res Treat. 2020; 183: 161-175