ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2019
Combined quantitative measures of ER, PR, HER2, and KI67 provide more prognostic information than categorical combinations in luminal breast cancer.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 1 of them a synthesis that pooled it.
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Who cites it
45 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Adipogenesis biomarkers as the independent predictive factors for breast cancer recurrence: a systematic review and meta-analysis.BMC cancer · 2024Pooled it
- Ki-67 as a treatment decision modifier in breast cancer.The oncologist · 2026Article
- Validation of IHC4 + C for male breast cancer.Virchows Archiv : an international journal of pathology · 2026Article
- Investigation of immunohistochemical marker expression in breast cancer of varying severity and construction of a predictive model.Translational cancer research · 2026Article
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- Genetic Signature of Breast Cancer Defines Therapeutic Interventions and Indicates Early Drug Resistance.Journal of cellular and molecular medicine · 2025Review
- Revolutionizing breast cancer immunotherapy by integrating AI and nanotechnology approaches: review of current applications and future directions.Bioelectronic medicine · 2025Review
- Beyond traditional biopsies: the emerging role of ctDNA and MRD on breast cancer diagnosis and treatment.Discover oncology · 2025Review
- Network-based transfer of pan-cancer immunotherapy responses to guide breast cancer prognosis.NPJ systems biology and applications · 2025Article
- Multimodal diagnostic models and subtype analysis for neoadjuvant therapy in breast cancer.Frontiers in immunology · 2025Article
- Metabolomics-Based Machine Learning Models Accurately Predict Breast Cancer Estrogen Receptor Status.International journal of molecular sciences · 2024Article
- Construction of a novel mitochondrial oxidative stress-related genes prognostic system and molecular subtype characterization for breast cancer.Discover oncology · 2024Article
- Breast cancer immunotherapy: Realities and advances.Cancer innovation · 2024Review
- Article
- Differences in Histological Subtypes of Invasive Lobular Breast Carcinoma According to Immunohistochemical Molecular Classification.Diagnostics (Basel, Switzerland) · 2024Article
- The role of ATP6V0D2 in breast cancer: associations with prognosis, immune characteristics, and TNBC progression.Frontiers in oncology · 2024Article
- A Study on the Factors and Prediction Model of Triple-Negative Breast Cancer for Public Health Promotion.Diagnostics (Basel, Switzerland) · 2023Article
- The Role of Nodes and Nodal Assessment in Diagnosis, Treatment and Prediction in ER+, Node-Positive Breast Cancer.Journal of personalized medicine · 2023Review
- Ki67 increase after core needle biopsy associated with worse disease outcome in HER2-negative breast cancer patients.Scientific reports · 2023Article
- PI3K-AKT-Targeting Breast Cancer Treatments: Natural Products and Synthetic Compounds.Biomolecules · 2023Review
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11 authors.
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Abstract
Although most women with luminal breast cancer do well on endocrine therapy alone, some will develop fatal recurrence thereby necessitating the need to prospectively determine those for whom additional cytotoxic therapy will be beneficial. Categorical combinations of immunohistochemical measures of ER, PR, HER2, and KI67 are traditionally used to classify patients into luminal A-like and B-like subtypes for chemotherapeutic reasons, but this may lead to the loss of prognostically relevant information. Here, we compared the prognostic value of quantitative measures of these markers, combined in the IHC4-score, to categorical combinations in subtypes. Using image analysis-based scores for all four markers, we computed the IHC4-score for 2498 patients with luminal breast cancer from two European study populations. We defined subtypes (A-like (ER + and PR + : and HER2- and low KI67) and B-like (ER + and/or PR + : and HER2 + or high KI67)) by combining binary categories of these markers. Hazard ratios and 95% confidence intervals for associations with 10-year breast cancer-specific survival were estimated in Cox proportional-hazard models. We accounted for clinical prognostic factors, including grade, tumor size, lymph-nodal involvement, and age, by using the PREDICT-score. Overall, Subtypes [hazard ratio (95% confidence interval) B-like vs. A-like = 1.64 (1.25-2.14); P-value < 0.001] and IHC4-score [hazard ratio (95% confidence interval)/1 standard deviation = 1.32 (1.20-1.44); P-value < 0.001] were prognostic in univariable models. However, IHC4-score [hazard ratio (95% confidence interval)/1 standard deviation = 1.24 (1.11-1.37); P-value < 0.001; likelihood ratio chi-square (LRχ
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