In fact, IHC is methodologically error-prone, as it is a multi-step process, highly exposed to variabilities of various kinds, such as from the use of non-standardized local practices or from different, non-equally performing albeit approved reagents. Thus, it is not surprising that assessing the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor two (HER2) and proliferation remains the cornerstone of breast cancer diagnosis and treatment, although the well-known problems of accuracy and reproducibility which have necessitated the issuing of various guidelines, are still persistent. Recent molecular studies have lent further support to the historical importance of hormone receptors, growth factors and perturbations in proliferation as the key operators of breast cancer initiation and progression. Analysis of breast cancer tissues by pathologists generates a wealth of information that can be used to classify disease for prognostic purposes and help guide therapeutic decisions.
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