Hi Histonetters, we are wondering what everyone else out there is doing to be 
compliant with the following requirement?  We do ER and PR by IHC  but dont 
know what published benchmarks are out there to compare ourselves to.  Also, 
how do you record interobserver variability amongst the pathologists?  Any 
insights into this would be appreciated.



ANP.22970 Annual Result Comparison Phase II
For immunohistochemical and FISH/ISH tests that provide independent predictive
information, the laboratory at least annually compares its patient results with 
published
benchmarks, and evaluates interobserver variability among the pathologists in 
the
laboratory.
NOTE: Individuals interpreting the assay must also have their concordance 
compared with each
other and this concordance should also be at least 95%.
With specific reference to estrogen and progesterone receptor studies: in 
general, the overall
proportion of ER-negative breast cancers (invasive and DCIS) should not exceed 
30%. The
proportion is somewhat lower in postmenopausal than premenopausal women 
(approximately
20% vs. 35%). The proportion is considerably lower in well-differentiated 
carcinomas (<10%)
and certain special types of invasive carcinomas (<10% in lobular, tubular, and 
mucinous types).
The proportion of PgR-negative cases is 10-15% higher than for ER-negative in 
each of these
settings. Investigation is warranted if the proportion of negative cases is 
significantly lower in any
of these settings.

Joanne Clark, HT
Director of Histology
Pathology Consultants of New Mexico
Roswell, New Mexico




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