Immunohistochemical Assay for Oestrogen Receptors in Paraffin Wax Sections of Breast Carcinoma Using a New Monoclonal Antibody

The aim of this study was to evaluate the utility of a new monoclonal antibody (AER311) that targets the oestrogen receptor (ER) in an immunohistochemical assay (IHA) applied to breast cancers. Ninety-seven cases of invasive ductal carcinoma were studied by AER311-IHA using a pressure-cooking antigen retrieval technique applied to formaldehyde-fixed, paraffin-embedded tissue sections; immunostaining was assessed by semi-quantitative scoring (H score). There was 80 per cent concordance between the ER status measured by dextran-coated charcoal (DCC) assay and AER311-IHA, with 63/97 (65 per cent) tumours positive and 15/97 (15 per cent) tumours negative by both assays. Of the 12 DCC-positive cases that were negative by AER311-IHA, 11 were borderline positive (3-8 fmol/mg). Similarly, six of seven DCC-negative cases that scored positive by AER311-IHA had only borderline positive H scores (< 50). When AER311-IHA was compared with ID5-IHA, there was good concordance in ER status (77 per cent) and a significant correlation (r = 0.7, P < 0.001) between H scores. Nevertheless, the correlation between ER level determined by AER311-IHA and that measured by DCC (r = 0.53, P < 0.001) was higher than that for 1D5-IHA (r = 0.32, P = 0.002). AER311-IHA can therefore provide reliable information about the ER status of breast carcinoma on paraffin sections and is an acceptable alternative to other commercially available monoclonal antibodies.