Estrogen Receptor (ER) belongs to a superfamily of nuclear hormone receptors and is expressed in about 85% of invasive breast cancers. There are two known isoforms of estrogen receptor, ERα and ERß. It is a weak prognostic factor but a strong predictive factor for response to endocrine therapies, both in adjuvant and metastatic settings. The primary indication to assess ER in breast cancer is to predict response to hormonal therapies such as tamoxifen, other selective estrogen receptor modulators (SERMs) and aromatase inhibitors. In univariate analysis, moderate to strong staining in even 1% of the invasive tumor cells is associated with significant improvement in disease-free survival compared to those patients whose tumor lacks ER expression.
ER
- Immunohistochemistry (IHC)
Specimen Requirements
Preferred specimen (FFPE block):
A formalin-fixed, paraffin-embedded (FFPE) tissue block is the preferred specimen type. Use 10% NBF fixative; do not use zinc or mercury fixatives.
If submitting slides (instead of a block):
Submit the following. All slides cut at 4–5 microns. Please use positively-charged slides and 10% NBF fixative.
H&E slide: One (1) unbaked, unstained slide for H&E staining (required)
Cut Slides: Two (2) positively charged unstained slides for each IHC test/antibody ordered
Specimen identification:
Block and slide identifiers should be clearly written and match exactly with the specimen ID and specimen labeling as noted on the requisition.
A formalin-fixed, paraffin-embedded (FFPE) tissue block is the preferred specimen type. Use 10% NBF fixative; do not use zinc or mercury fixatives.
If submitting slides (instead of a block):
Submit the following. All slides cut at 4–5 microns. Please use positively-charged slides and 10% NBF fixative.
H&E slide: One (1) unbaked, unstained slide for H&E staining (required)
Cut Slides: Two (2) positively charged unstained slides for each IHC test/antibody ordered
Specimen identification:
Block and slide identifiers should be clearly written and match exactly with the specimen ID and specimen labeling as noted on the requisition.
Storage and Transportation
Slides may be stored at room temperature; transport with cold pack, making sure cold pack is not in direct contact with specimen.
NYS Clients: Please provide Date and Time of Collection.
CPT Code(s)*
88342 x 1 or 88341 x 1; 88361 x 1; 88360 x 1
Turnaround time
1-2 Days
Image Analysis for Global: 2 Days
Image Analysis for (Tech-Only): 2 Days
Tech-Only (stain only): 24 Hours
Level of Service
- Global
- Tech Only
Integrations
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New York Approved: Yes
*The CPT codes provided with our test descriptions are based on AMA guidelines and are for informational purposes only. Correct CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed.
Biomarkers
Immunohistochemistry (IHC)
| Expression | |||||
|---|---|---|---|---|---|
| ER | |||||
Last Updated: March 19, 2026