Alred Score

DianneS · 08-27-2009, 08:56 PM

Ahhh....yet another question! I am told that on the Alred Score (do they do these in the States? I had not heard of it and may be mispelling it) I am a 4, which means I would significantly benefit from hormone therapy. My new onc said that I don't have a lot of estrogen receptors - I am weakly positive - but those I do have lit up strongly. Is this weird or what?

This may help some of you out there who are in this minority group of weakly ER positive women, who are trying to decide if hormone therapy would benefit them or not.

Please let me know if you have heard of this Alred Score. I'm in Canada so maybe it's just done here.

Diannes
One year 'anniversary' today!!!! NED......

Hopeful · 08-28-2009, 07:19 AM

DianneS,

The name of the test is the Allred, not Alred score, so the misspelling may have hindered your research. It is named for the Dr. who invented it, Craig Allred. One of the under the radar issues in breast cancer treatment is the lack of consistency in ER testing and interpretation. A similar issue with regard to Her2+ testing a few years ago had a much higher profile. Most of the ER testing done today is by immunohistochemical testing (IHC), which tells you the percentage of cells in the tumor that are positive for ER. Dr. Allred's method looks not just at the number of cells staining positively for ER, but to the intensity of the staining, and uses both in a formula to arrive at a single score. The issue is that labs will use a cut-off point (again, there is no consistency for where that is) to classify a tumor as "ER-". So, a tumor with 5% or 10% ER+ cells can be classified as "ER-," and the patient not be offered hormonal therapy. Dr. Allred's point is that patients with a low number of ER+ cells that stain deeply (indicating they are highly responsive to hormonal therapy) may be misclassified if only IHC testing is used.

Here are a few links to articles you can read about it:

http://jco.ascopubs.org/cgi/content/full/23/22/5148#R11

http://www.breastcancerupdate.com/sa...o/2004/sa2.pdf

I wish I lived in an area where Allred testing was standard. You are very fortunate. Congratulations on your one year anniversary.

Hopeful

Debbie L. · 08-28-2009, 07:42 AM

Another reason to send your slides and tumor blocks out for a second opinion. I sent mine to Baylor (really simple), where they use the Allred score.

I think Dr. Allred was at Baylor then, although he's now somewhere in the midwest - Washington University maybe.

When I did this, there was a lot of information on the Baylor website, and a form to download and fill out to enclose. But they've completely changed their website and all I can find is a contact link (email) for setting up a second opinion pathology consult:

http://www.bcm.edu/pathology/patients/service.htm

Debbie Laxague