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Immunohistochemistry and Multigene Assays in Breast Cancer

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Gene signatures which are based on multigene profiling assays have been developed for the purpose to better define the prognosis and prediction of therapy results in early-stage breast cancer. These assays were designed to be more specific than conventional clinico-pathologic parameters in the selection of patients for (neo-)adjuvant treatment and in effect help to avoid unnecessary cytotoxic treatment (Geburtshilfe Frauenheilkd. 2013 Sep;73(9):932-940). This presentation reviews the terms of these assays, analytical strengths of the assays, correlation between methodologies, and model for integrating assays in laboratories.

Learning Objectives:

  1. Overview of the differences between immunohistochemistry and multigene assays in terms of, methodology, analytes, quantitative accuracy and precision, and susceptibility to contamination by non-tumor cells.
  2. Review the analytical strengths and limitations of immunohistochemistry and multigene assays used in breast cancer prognostic/predictive testing.
  3. Explain and outline an approach to retrospectively or prospectively correlate immunohistochemistry results with multigene assay results on breast cancer cases from an institution.
  4. Discuss a model for integrating immunohistochemistry results in the decision process for ordering breast cancer prognostic/predictive multigene assay tests.

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