Unifying Concepts

Allred Score for Estrogen and Progesterone Receptor Evaluation

Breast cancer (BC) hormonal receptors status is assessed by immunohistochemistry (IHC), a specific, sensitive, and accessible method that guide breast cancer treatment.

Reporting Results of Estrogen Receptor and Progesterone Receptor Testing





Immunoreactive tumor cells present (>/=1%)

The percentage of immunoreactive cells may be determined by visual estimation or quantitation. Quantitation can be provided by reporting the percentage of positive cells or by a scoring system, such as the Allred score or the H score.


<1% immunoreactive tumor cells present


Allred Score for Estrogen and Progesterone Receptor Evaluation

Positive Cells, % Proportion Score Intensity Intensity Score
0 0 None 0
<1 1 Weak 1
1-10 2 Intermediate 2
11–33 3 Strong 3
34–66 4
>/=67 5

The Allred score combines the percentage of positive cells and the intensity of the reaction product in most of the carcinoma. The 2 scores are added together for a final score with 8 possible values. Scores of 0 and 2 are considered negative. Scores of 3-8 are considered positive.

H Score for Estrogen and Progesterone Receptor Evaluation

Cell Signal Calculation of H Score
Percentage of Cells Value Multiplied
Cells with no signal % x0=
Cells with weak signal % x1=
Cells with moderate signal % x2=
Cells with strong signal % x3=
Total score =

The H score is determined by multiplying the percentage of cells demonstrating each intensity (scored from 0 to 3) and adding the results. There are 300 possible values. In this system, <1% positive cells is considered to be a negative result.



  1. Fitzgibbons PL, Dillon DA, Alsabeh R, Berman MA, Hayes DF, Hicks DG, Hughes KS, Nofech-Mozes S. Template for reporting results of biomarker testing of specimens from patients with carcinoma of the breast. Arch Pathol Lab Med. 2014 May;138(5):595-601. [Medline]
  2. Daltoé RD, Madeira KP, de Carvalho AA, de Rezende LC, Silva IV, Rangel LB. Evaluation of the progesterone receptor status in breast cancer using three different antibodies: a comparison by Allred score system. Int J Clin Exp Pathol. 2013 Dec 15;7(1):331-9. [Medline]
  3. Hammond ME, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, Fitzgibbons PL, Francis G, Goldstein NS, Hayes M, Hicks DG, Lester S, Love R, Mangu PB, McShane L, Miller K, Osborne CK, Paik S, Perlmutter J, Rhodes A, Sasano H, Schwartz JN, Sweep FC, Taube S, Torlakovic EE, Valenstein P, Viale G, Visscher D, Wheeler T, Williams RB, Wittliff JL, Wolff AC; American Society of Clinical Oncology; College of American Pathologists. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer (unabridged version). Arch Pathol Lab Med. 2010 Jul;134(7):e48-72. [Medline]


Created Feb 06, 2018.

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