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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

08-28-2009, 07:19 AM	#2
Hopeful Senior Member Join Date: Aug 2006 Posts: 3,380	Re: Alred Score 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