Assessment of the reliability of immunocytochemical detection of estrogen and progesterone receptors status on the cytological aspirates of breast carcinoma

Purpose : evaluation of the reliability of immunocytochemical staining for estrogen and progesterone receptor status on previously papanicolaou-stained fine needle aspiration smears of breast carcinoma cases. Patients and Methods : this is a retrospective study conducted on detained smears of fine needle aspirates (FNA) obtained from 90 breast carcinoma cases. These cases underwent subsequent tumor resection and immunohistochemical detection of estrogen and progesterone receptors allowing a comparison between the immunocytochemical and immunohistochemical results (Gold Standard). Hypocelluar slides were excluded from the current study. Only the nuclear staining was considered specific. The results were scored on the basis of the percentage of the positive nuclei among the total epithelial malignant cells after examination of the entire slide. Smears were interpreted as positive if ³10 % of the examined cells demonstrated nuclear staining. These results were then compared with the immunohistochemical results. Results : for estrogen receptor immunocytochemistry, the overall cyto-histologic accuracy was 91.1 % (82 / 90). while the discordance rate was 8.9 % (8 / 90). The diagnostic sensitivity, specificity, positive predictive value, and negative predictive value were 93 %, 84.2 %, 95.7 %, and 76.2 % respectively. For progesterone receptor immunocytochemistry, the overall cyto-histologic accuracy was 88.9 % (80 / 90) while the discordance rate was 11.1 % (10 / 90). The diagnostic sensitivity, specificity, positive predictive value, and negative predictive value were 87.1%, 95 %, 98.4 %, and 67.9% respectively. Conclusion : immunocytochemistry is considered as an efficient tool in evaluating estrogen and progesterone receptor status in breast carcinoma. The application of estrogen and progesterone receptor immunocytochemistry on previously Papanicolaou-stained slides provides an overall accuracy of 91.1 % for estrogen receptor and 88.9 % for progesterone receptor when compared with the immunohistochemical results.