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REVIEW ARTICLE
Year : 2017  |  Volume : 146  |  Issue : 4  |  Page : 449-458

Improving accuracy of breast cancer biomarker testing in India


Department of Histopathology, Tata Memorial Centre, Mumbai, India

Correspondence Address:
Dr. Tanuja Shet
Department of Histopathology, 8th Floor, Annexe Building, Tata Memorial Centre, Dr E Borges Road, Parel, Mumbai 400 012, Maharashtra
India
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Source of Support: None, Conflict of Interest: The author is on Roche Advisory board for biomarker testing in India and member of the SPHERE programme.


DOI: 10.4103/ijmr.IJMR_896_16

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There is a global mandate even in countries with low resources to improve the accuracy of testing biomarkers in breast cancer viz. oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2neu) given their critical impact in the management of patients. The steps taken include compulsory participation in an external quality assurance (EQA) programme, centralized testing, and regular performance audits for laboratories. This review addresses the status of ER/PR and HER2neu testing in India and possible reasons for the delay in development of guidelines and mandate for testing in the country. The chief cause of erroneous ER and PR testing in India continues to be easily correctable issues such as fixation and antigen retrieval, while for HER2neu testing, it is the use of low-cost non-validated antibodies and interpretative errors. These deficiencies can however, be rectified by (i) distributing the accountability and responsibility to surgeons and oncologist, (ii) certification of centres for testing in oncology, and (iii) initiation of a national EQA system (EQAS) programme that will help with economical solutions and identifying the centres of excellence and instill a system for reprimand of poorly performing laboratories.


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