Immunohistochemical estrogen receptor determination in paraffin-embedded tissue. Prediction of response to hormonal treatment in advanced breast cancer

Cancer. 1989 Nov 1;64(9):1901-8. doi: 10.1002/1097-0142(19891101)64:9<1901::aid-cncr2820640924>;2-w.


A new immunohistochemical assay using a monoclonal estrogen receptor (ER) antibody (H222, Abbott Laboratories, North Chicago) for determination of ER in formalin-fixed paraffin-embedded tissue was applied to evaluate its clinical value in a group of 145 previously untreated patients with advanced breast cancer. Suitable histologic material was accessible in 137 of these patients, of whom 70% had ER-positive tumors. The ER-positive patients had a significantly longer median overall survival than ER-negative patients (67 versus 32 months, P much less than 0.001) and this was an effect of both a prolonged disease-free interval (27 versus 17 months, P less than 0.05) and a prolonged survival after recurrence (41 versus 15 months, P much less than 0.001). Response to endocrine therapy was obtained in 49% of the patients with ER-positive tumors and in 7% with ER-negative tumors (P much less than 0.001). Relationship between response and semiquantified individual staining features could not be established. It is concluded that ER analysis in formalin-fixed paraffin-embedded tissue offers clinically useful information for allocation of patients to endocrine therapy.

MeSH terms

  • Aged
  • Aminoglutethimide / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / mortality
  • Diethylstilbestrol / administration & dosage
  • Female
  • Fluoxymesterone / administration & dosage
  • Humans
  • Immunohistochemistry
  • Menopause
  • Middle Aged
  • Neoplasm Recurrence, Local / mortality
  • Paraffin
  • Receptors, Estrogen / analysis*
  • Survival Analysis
  • Tamoxifen / administration & dosage
  • Tamoxifen / therapeutic use*


  • Receptors, Estrogen
  • Tamoxifen
  • Aminoglutethimide
  • Diethylstilbestrol
  • Paraffin
  • Fluoxymesterone