{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:06:46Z","timestamp":1790730406613,"version":"4.1.0"},"reference-count":37,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T00:00:00Z","timestamp":1638835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,6,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Biomarker expression evaluation for estrogen receptor (ER), progesterone receptor (PgR), and human epidermal growth factor receptor 2 (HER2) is an essential prognostic and predictive parameter for breast cancer and critical for guiding hormonal and neoadjuvant therapy. This study compared quantitative image analysis (QIA) with pathologists\u2019 scoring for ER, PgR, and HER2.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective analysis was undertaken of 1,367 invasive breast carcinomas, including all histopathology subtypes, for which ER, PgR, and HER2 were analyzed by manual scoring and QIA. The resulting scores were compared, and in a subset of HER2 cases (n = 373, 26%), scores were correlated with available fluorescence in situ hybridization (FISH) results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Concordance between QIA and manual scores for ER, PgR, and HER2 was 93%, 96%, and 90%, respectively. Discordant cases had low positive scores (1%-10%) for ER (n = 33), were due to nonrepresentative region selection (eg, ductal carcinoma in situ) or tumor heterogeneity for PgR (n = 43), and were of one-step difference (negative to equivocal, equivocal to positive, or vice versa) for HER2 (n = 90). Among HER2 cases where FISH results were available, only four (1.0%) showed discordant QIA and FISH results.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>QIA is a computer-aided diagnostic support tool for pathologists. It significantly improves ER, PgR, and HER2 scoring standardization. QIA demonstrated excellent concordance with pathologists\u2019 scores. To avoid pitfalls, pathologist oversight of representative region selection is recommended.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajcp\/aqab206","type":"journal-article","created":{"date-parts":[[2021,11,8]],"date-time":"2021-11-08T20:12:52Z","timestamp":1636402372000},"page":"899-907","source":"Crossref","is-referenced-by-count":23,"title":["Quantitative Image Analysis as an Adjunct to Manual Scoring of ER, PgR, and HER2 in Invasive Breast Carcinoma"],"prefix":"10.1093","volume":"157","author":[{"given":"Mustafa","family":"Yousif","sequence":"first","affiliation":[{"name":"Department of Pathology, University of Michigan Medical School , Ann Arbor, MI \u00b8 USA"},{"name":"Department of Pathology, Vanderbilt University Medical Center , Nashville, TN \u00b8 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiyuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Michigan , Ann Arbor, MI \u00b8 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Sciallis","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan Medical School , Ann Arbor, MI \u00b8 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Celina G","family":"Kleer","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan Medical School , Ann Arbor, MI \u00b8 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan Medical School , Ann Arbor, MI \u00b8 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Smola","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan Medical School , Ann Arbor, MI \u00b8 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kalyani","family":"Naik","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan Medical School , Ann Arbor, MI \u00b8 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S","family":"McClintock","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan Medical School , Ann Arbor, MI \u00b8 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6366-8206","authenticated-orcid":false,"given":"Lili","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Michigan , Ann Arbor, MI \u00b8 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lakshmi P","family":"Kunju","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan Medical School , Ann Arbor, MI \u00b8 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulysses G J","family":"Balis","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan Medical School , Ann Arbor, MI \u00b8 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liron","family":"Pantanowitz","sequence":"additional","affiliation":[{"name":"Department of Pathology, University of Michigan Medical School , Ann Arbor, MI \u00b8 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,12,7]]},"reference":[{"key":"2023020615124596200_CIT0001","first-page":"6","article-title":"Breast cancer and associated factors: a review","volume":"8","author":"Ataollahi","year":"2015","journal-title":"J Med Life"},{"key":"2023020615124596200_CIT0002","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/S1040-8428(99)00034-7","article-title":"Pathological prognostic factors in breast 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