PURPOSE To update key recommendations of the American Society of Clinical Oncology/College of American Pathologists estrogen (ER) and progesterone receptor (PgR) testing in breast cancer guideline. METHODS A multidisciplinary international Expert Panel was convened to update the clinical practice guideline recommendations informed by a systematic review of the medical literature. RECOMMENDATIONS The Expert Panel continues to recommend ER testing of invasive breast cancers by validated immunohistochemistry as the standard for predicting which patients may benefit from endocrine therapy, and no other assays are recommended for this purpose. Breast cancer samples with 1% to 100% of tumor nuclei positive should be interpreted as ER positive. However, the Expert Panel acknowledges that there are limited data on endocrine therapy benefit for cancers with 1% to 10% of cells staining ER positive. Samples with these results should be reported using a new reporting category, ER Low Positive, with a recommended comment. A sample is considered ER negative if < 1% or 0% of tumor cell nuclei are immunoreactive. Additional strategies recommended to promote optimal performance, interpretation, and reporting of cases with an initial low to no ER staining result include establishing a laboratory-specific standard operating procedure describing additional steps used by the laboratory to confirm/adjudicate results. The status of controls should be reported for cases with 0% to 10% staining. Similar principles apply to PgR testing, which is used primarily for prognostic purposes in the setting of an ER-positive cancer. Testing of ductal carcinoma in situ (DCIS) for ER is recommended to determine potential benefit of endocrine therapies to reduce risk of future breast cancer, while testing DCIS for PgR is considered optional. Additional information can be found at www.asco.org/breast-cancer-guidelines.

中文翻译：

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乳腺癌中的雌激素和孕激素受体检测：ASCO/CAP 指南更新

目的 更新美国临床肿瘤学会/美国病理学家学会雌激素 (ER) 和孕激素受体 (PgR) 检测乳腺癌指南的主要建议。方法 召集了一个多学科国际专家小组，根据对医学文献的系统回顾更新临床实践指南建议。建议 专家小组继续推荐通过经过验证的免疫组织化学对浸润性乳腺癌进行 ER 检测，作为预测哪些患者可能从内分泌治疗中获益的标准，并且没有推荐其他检测方法用于此目的。具有 1% 至 100% 肿瘤细胞核阳性的乳腺癌样本应被解释为 ER 阳性。然而，专家小组承认，关于内分泌治疗对 1% 至 10% ER 染色细胞阳性的癌症有益的数据有限。应使用新的报告类别 ER 低阳性报告具有这些结果的样本，并附上建议的评论。如果 < 1% 或 0% 的肿瘤细胞核具有免疫反应性，则样品被视为 ER 阴性。建议的其他策略可促进最佳性能、解释和报告初始低 ER 染色结果或无 ER 染色结果的病例，包括建立实验室特定的标准操作程序，描述实验室用于确认/裁定结果的其他步骤。对于染色为 0% 至 10% 的病例，应报告对照状态。类似的原则适用于 PgR 测试，主要用于 ER 阳性癌症的预后目的。建议对导管原位癌 (DCIS) 进行 ER 检测，以确定内分泌治疗的潜在益处，以降低未来患乳腺癌的风险，同时对 DCIS 进行 PgR 检测被认为是可选的。更多信息可在 www.asco.org/breast-cancer-guidelines 上找到。