Reproducibility of subjective immunoscoring of steroid receptors in breast cancer

Paul J. Van Diest, Dolfi R. Weger, Johan Lindholm

Research output: Contribution to journalArticlepeer-review

24 Scopus citations


OBJECTIVE: To evaluate the reproducibility of subjective immunoscoring of steroid receptors in breast cancer by inexperienced observers after brief training by one experienced observer. STUDY DESIGN: Thirteen inexperienced observers were trained for a few minutes semiquantitatively (0-4) to score tumor nuclei in two breast cancer frozen sections immunohistochemically stained each for estrogen or progesterone receptors. Then, the fractions of 0, 1, 2, 3 and 4 'stained' nuclei were estimated individually. Thereafter, the experienced observer pointed out the nuclei one by one, and the participants score these nuclei individually. From these data, histoscores were calculated. RESULTS: When comparing individual scorings (n = 1,320) with the gold standard, discrepancies occurred mainly between scores and 2 and 3, and the best concordance was achieved for the scores 0 and 4. For the histoscores, coefficients of variations for the estimated scores (7.3-33.7, mean 17.2) were systematically higher than those derived from nucleus-by- nucleus scoring (2.6-15.4, mean 10.3). CONCLUSION: Inexperienced observers can be trained quickly to arrive at fairly reproducible histoscores for immunohistochemically stained estrogen and progesterone receptors in breast cancer frozen sections. Nucleus-by-nucleus scoring seems to be more reproducible than estimating fractions of nuclei with certain positivity and should be recommended in cases of values close to the decision threshold.

Original languageEnglish (US)
Pages (from-to)351-354
Number of pages4
JournalAnalytical and Quantitative Cytology and Histology
Issue number5
StatePublished - Oct 1996
Externally publishedYes


  • breast neoplasms
  • estrogen receptors
  • immunohistochemistry
  • progesterone receptors
  • reproducibility of results

ASJC Scopus subject areas

  • Anatomy
  • Histology


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