Name of the Procedure:

Quantitative non-HER2 immunohistochemistry (IHC) evaluation of breast cancer (e.g., testing for estrogen or progesterone receptors [ER/PR])

Summary

Quantitative non-HER2 immunohistochemistry (IHC) is a lab test performed on breast cancer tissue to determine the presence and amount of estrogen and progesterone receptors (ER/PR) in cancer cells. This helps guide treatment decisions based on the hormone receptor status of the cancer.

Purpose

• Medical Condition Addressed: Breast cancer.
• Goals and Outcomes: To identify the presence of hormone receptors (ER/PR) on breast cancer cells to determine if hormone therapy can be an effective treatment option.

Indications

• Breast cancer diagnosis.
• Determining eligibility for hormone therapy.
• Patients with newly diagnosed breast cancer or recurrent breast cancer.

Preparation

• No special preparation is usually required for the patient.
• Tissue samples are typically obtained from a biopsy or surgery to remove the tumor.

Procedure Description

1. Sample Collection: Tissue sample obtained through biopsy or surgery.
2. Lab Processing: The tissue sample is processed and prepared on slides.
3. IHC Staining: Specific antibodies are applied to the tissue to bind to estrogen or progesterone receptors if present.
4. Microscopic Evaluation: A pathologist examines the stained tissue under a microscope to quantify the percentage and intensity of staining, indicating the presence and amount of ER/PR receptors.

• Tools and Equipment: Microscope, staining reagents, antibodies specific to ER/PR receptors.
• Anesthesia or Sedation: Not applicable for the IHC evaluation itself but may be used during the biopsy or surgical collection of the tissue sample.

Duration

The lab analysis typically takes a few hours to a day after the tissue sample is prepared.

Setting

The procedure is performed in a pathology laboratory.

Personnel

• Pathologists specialize in diagnosing disease from laboratory tests.
• Lab technicians.

Risks and Complications

• Common: Minimal risks because the procedure itself is lab-based and non-invasive; the primary risk is related to the biopsy or surgical collection of the tissue sample.
• Rare: Misinterpretation of results, sample contamination.

Benefits

• Provides critical information on hormone receptor status, helping to personalize breast cancer treatment.
• Enables the effective use of hormone therapies, which can be less aggressive and have fewer side effects.

Recovery

• No recovery is necessary for the lab analysis itself.
• Post-biopsy or surgical care varies depending on the method used to obtain the tissue sample.

Alternatives

• Alternative diagnostic tests include genetic profiling or other molecular diagnostic tests.
• Pros: May provide additional information on cancer characteristics.
• Cons: May be more expensive or less specific for ER/PR status.

Patient Experience

• During the biopsy or surgery: Some discomfort or pain may be managed with local anesthesia or sedation.
• After the biopsy or surgery: Possible mild pain, swelling, or bruising at the collection site, managed with over-the-counter pain medications.
• No direct discomfort from the IHC evaluation as it is performed on the collected tissue sample.