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Journal of Cancer Prevention

Original Article

J Cancer Prev 2023; 28(2): 64-74

Published online June 30, 2023

© Korean Society of Cancer Prevention

Immunohistochemistry versus PCR Technology for Molecular Subtyping of Breast Cancer: Multicentered Expereinces from Addis Ababa, Ethiopia

Dessiet Oma1 , Maria Teklemariam1 , Daniel Seifu2 , Zelalem Desalegn3 , Endale Anberbir4 , Tamrat Abebe3 , Solomon Mequannent5 , Solomon Tebeje1 , Wajana Lako Labisso6

1Department of Medical Biochemistry, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia, 2Department of Biochemistry, University of Global Health Equity, Kigali, Rwanda, 3Department of Microbiology, Immunology, and Parasitology, 4Department of Surgery, School of Medicine, College of Health Sciences, Addis Ababa University, 5Department of Pharmacology, School of Pharmacy, College of Health Sciences, Addis Ababa University, 6Department of Pathology, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia

Correspondence to :
Wajana Lako Labisso, E-mail:,

Received: January 28, 2023; Revised: April 25, 2023; Accepted: April 26, 2023

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


The application of immunohistochemistry (IHC) for molecular characterization of breast cancer (BC) is of paramount importance; however, it is not universally standardized, subject to observer variability and quantifying is a challenge. An alternative molecular technology, such as endpoint reverse transcription (RT)-PCR gene expression analysis, may improve observer variability and diagnostic accuracy. This study was intended to compare IHC with the RT-PCR based technique and assess the potential of RT-PCR for molecular subtyping of BC. In this comparative cross-sectional study, 54 BC tissues were collected from three public hospitals in Addis Ababa and shipped to Gynaecology department at Martin-Luther University (Germany) for laboratory analysis. Only 41 samples were qualified for IHC and RT-PCR investigation of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki-67 protein expression analysis. Kappa statistics was used to assess the concordance between the two techniques. The overall percent agreement between RT-PCR and IHC was 68.3% for ER (positive percent agreement [PPA] 71.1%; negative percent agreement [NPA] 33.3%), 39.0% for PR (PPA 14.3%; NPA 92.3%), and 82.9% for HER2 (PPA 62.5%; NPA 87.9%). Cohen’s κ-values of 0.018 (< 0.20), 0.045 (< 0.200), and 0.481 (0.41-0.60) were generated for ER, PR, and HER2, respectively. Concordance for molecular subtypes was only 56.1% (23/41) and 0.20 kappa value. IHC and endpoint RT-PCR techniques have shown to be discordant for 43% samples. Molecular subtyping using endpoint RT-PCR was fairly concordant with IHC. Thus, endpoint RT-PCR may give an objective result, and can be applied for BC subtyping.

Keywords: Breast cancer, Molecular subtypes, Immunohistochemistry, Reverse transcription polymerase chain reaction

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