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Ensuring effective estrogen receptor testing

NHS England has today provided interim advice to NHS organisations in light of a CQC investigation and a Royal College of Pathologists report earlier this year into breast cancer receptor testing.

Advice to the NHS is that where histopathology laboratories are performing breast cancer receptor testing, they should ensure that the antibodies used for estrogen receptor testing are being used according to NEQAS or manufacturers’ instructions to prevent over-sensitivity.  Further, the relative performance of services should be reviewed as part of clinical governance and audits of receptor positivity rates should be carried out and benchmarked against other laboratories.  In addition it is advised that the results of progesterone receptor staining should not form the basis of clinical decision making.

Further details are provided in a letter from the National Clinical Director for Pathology that has been published and NHS organisations have been advised to draw the letter to the attention of their pathology departments.