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| Autor principal: | |
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| Formato: | Recurso digital |
| Idioma: | inglês |
| Publicado em: |
Zenodo
2026
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| Assuntos: | |
| Acesso em linha: | https://doi.org/10.5281/zenodo.18523786 |
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Sumário:
- <div> <div> <div> <p>Estrogen receptor (ER) immunohistochemistry (IHC) represents a central indicator in the classification of breast cancer and in guiding therapeutic decision-making. However, despite the inherently continuous and heterogeneous nature of ER expression, it is often interpreted in routine clinical practice on the basis of fixed cut-off values. In particular, cases showing weak ER staining are not adequately positioned within current classification systems, posing challenges in both diagnosis and treatment selection.</p> <p>This article re-examines ER IHC from biological and pathological perspectives and proposes a conceptual framework based on two independent parameters: the proportion of ER-positive tumour cells and ER staining intensity. These parameters should not be reduced to a single criterion nor an additive scoring system, but rather interpreted as orthogonal axes within a continuous and multidimensional biological space. Within this framework, ER expression cannot be regarded as a direct indicator of cellular proliferative capacity, but instead should be positioned as a marker reflecting tumour cell differentiation status and functional heterogeneity.</p> <p>Evaluation of ER expression based on fixed cut-off values may oversimplify continuous biological phenomena and give rise to structural ambiguity in treatment selection, particularly in weakly ER-positive tumours. This issue carries practical clinical significance in the current setting, where treatment algorithms presupposing ER status are incorporated into routine care.</p> <p>ER IHC should therefore be understood not merely as a binary positive-negative test, but as a semi-quantitative and multidimensional descriptor of tumour biology. Separate documentation and evaluation of the proportion of ER-positive cells and staining intensity may provide clinically meaningful information beyond binary classification and offer a conceptual foundation for reconsidering the role of pathological assessment in therapeutic decision-making.</p> </div> </div> </div>