Hormone- and HER2-receptor assessment in 33,046 breast cancer patients: a nationwide comparison of positivity rates between pathology laboratories in the Netherlands

• DOI: 10.1007/s10549-019-05180-5
• Publication Date: 2019-03-01T08:38:44Z
• Authors: Carmen van Dooije...; Ivette A. G. Deckers; Inge O. Baas; Elsken van der Wall; Paul J. van Diest
• Keywords: Cancer Research; Epidemiology; Receptor, ErbB-2; Breast Neoplasms; Hormone receptor; Inter-laboratory variation; 03 medical and health sciences; 0302 clinical medicine; HER2; Pathology; Biomarkers, Tumor; PALGA; Humans; Registries; Progesterone; Aged; Netherlands; Estrogens; Middle Aged; 3. Good health; Oncology; Receptors, Estrogen; Female; Receptors, Progesterone; Invasive breast cancer

Patient management of invasive breast cancer (IBC) is to a large extent based on hormone- and HER2-receptor assessment. High-quality, reliable receptor assessment key importance as false results may lead under- or overtreatment patients. Surveillance case-mix adjusted positivity rates has been suggested tool identify laboratories with insufficient testing assays, this covers the whole process enables benchmark their against other laboratories. We studied laboratory-specific variation in HER2 33,046 patients using real-life nationwide data. All synoptic pathology reports IBC resection-specimens, obtained between 2013 2016, were retrieved from Dutch registry (PALGA). Absolute compared mean national proportion presented funnel plots separate analyses for estrogen (ER), progesterone (PR) HER2. Case-mix adjustment was performed by multivariable logistic regression. 33,794 lesions 39 included. After adjustment, 87.2% ER (range 80.4–94.3), 71.3% PR (62.5–77.5%), 9.9% (5.5–12.7%). Overall, 14 (35.9%), 17 (43.6%) 11 (28.2%) showed outside 95% confidence interval ER, HER2, respectively. This study shows that absolute limited. Yet, considerable number outlying there still need improvement. Continuous monitoring benchmarking help realize this.