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We utilise our own in-house, standardised and validated tests, as well as commercially available assays for both Oestrogen and Progesterone receptors, providing a comprehensive and analytically robust service to the clinician.
Key facts about ER/PR
The value of morphological assessment can be enhanced by the use of a range of tissue based assays performed in our reference laboratory. These provide further information to aid in assessing prognosis, and perhaps more importantly in assessing adjuvant treatment suitability. One such test, recommended by NICE guidance, and which we are already providing to the NHS and private healthcare sectors, is the ER/PR test.
Oestrogen and progesterone receptor status is determined immunohistochemically. While providing some prognostic information, these paired tests are also used routinely in a treatment decision role, to determine suitability for hormone therapies such as Tamoxifen or aromatase inhibitors.
Immunostaining for ER and PR is evaluated visually by pathologists and laboratory scientists, and the result presented in the form requested by the client, as percentage positive cells, H-score or Allred Quickscore.
The H-score is a semi-quantitative system for assessing the intensity and distribution of positive staining with a range between 0 and 300. A score of 300 is achieved when 100% of the tumour cells show the highest level of intensity (scored as 0-3). A score above 10 is considered positive. A negative result for ER/PR is considered a poor prognostic sign, while a positive is an indicator for tamoxifen or other hormonal therapies.
The Quick score is a similar system with a range between 0 and 8. Scores of over 2 are considered positive.