At the two institutions where I have performed Er/PR, we did the tests on
DCIS as well as invasive and metastatic breast cancers. No data exists for
treatment of DCIS with hormonal ablation, but DCIS is often a multifocal
disease, and lobular CIS is often bilateral and multifocal and it follows
that hormonal ablation might be of benefit if there are undetected residual
foci of disease. As in invasive tumors, the poorer differentiated
comedo-type tumors tend not to express ER or PR. As an aside,
I have often said that in cases where there are lymph node metastases, it is
these that should be tested, ie the metastatic clone of cells, rather than
the primary tumor which may have multiple clones emerging- just look at the
difference in architecture in larger tumors. Any thoughts?

I still love my Cytologix/(Now Dako) Artisan for a compact, versatile
immunostainer AND special stainer, it does both on the same run. The silver
stains, AFB, trichrome, PAS are beautiful and they just keep on improving it
and now that Dako has it, look out- the sky is the limit. I have devised
protocols in our lab to use other manufacturer's antibodies not on the
Artisan menu incubating off the machine and then using Artisan detection. It
is trouble free and easy to use.

Jeff Silverman HT HTL QIHC (ASCP)
Pathologists' Assistant
Southside Hospital
Bay Shore New York