Abstract
Introduction: The most commonly encountered morphological preservation artifacts in the histological assessment of breast cancer include retraction of tumour cell clusters from the stroma, cytoplasmic retraction and alterations in nuclear morphology. This study intended to assess how these artifacts affect the quality of immunohistochemical (IHC) staining for ER and Her-2. Methods: For this retrospective study, 120 cases of consecutive breast cancers reported by the 2nd and 3rd authors during 2009 to 2010 were included. Haemotoxylin and Eosin stained sections of each breast cancer were assessed to obtain a consensus score for the degree of morphological preservation artifacts present. For each artifact (Retraction of tumour cell clusters, cytoplasmic retraction and alterations in nuclear morphology) a consensus score was given (0, 1, 2, 3) depending on the percentage of cell clusters/cells affected. Each IHC slide was assessed to obtain a consensus score for the quality of IHC staining for ER and Her-2. Parameters measured were uniformity of staining (0, 1), background staining (0, 1, 2), and adequacy of counterstaining (0, 1). Results: The study included a total of 120 consecutive breast cancer cases. There was no statistically significant relationship between the consensus score for the commonly encountered morphological preservation artifacts and the quality of IHC staining of ER (p = 0.44) and Her-2 (p = 0.51). Conclusions: Commonly encountered morphological preservation artifacts have no significant effect on the quality of IHC staining for ER and Her-2 measured in terms of uniformity of staining, background staining and adequacy of counterstaining. Galle Medical Journal, Vol 18: No. 2, September 2013;Page 8-12 DOI: http://dx.doi.org/10.4038/gmj.v18i2.6193
Highlights
The most commonly encountered morphological preservation artifacts in the histological assessment of breast cancer include retraction of tumour cell clusters from the stroma, cytoplasmic retraction and alterations in nuclear morphology
Since Tru-cut biopsies are immediately immersed in formalin and do not show preservation artifacts they were excluded from the sample
Preservation artifacts did not have a statistically significant effect on the quality of IHC staining for ER (p = 0.44) and the quality of IHC staining for human epidermal growth factor receptor 2 (Her-2) (p = 0.50)
Summary
The most commonly encountered morphological preservation artifacts in the histological assessment of breast cancer include retraction of tumour cell clusters from the stroma, cytoplasmic retraction and alterations in nuclear morphology. Haemotoxylin and Eosin stained sections of each breast cancer were assessed to obtain a consensus score for the degree of morphological preservation artifacts present. There was no statistically significant relationship between the consensus score for the commonly encountered morphological preservation artifacts and the quality of IHC staining of ER (p = 0.44) and Her-2 (p = 0.51). Conclusions: Commonly encountered morphological preservation artifacts have no significant effect on the quality of IHC staining for ER and Her-2 measured in terms of uniformity of staining, background staining and adequacy of counterstaining. Analysis of variance was used to compare the mean values of the quality of IHC staining (for ER and Her separately) for the above groups Both scoring systems were pre-tested before using on the study sample.
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