Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Do Clinical Features and Survival of Single Hormone Receptor Positive Breast Cancers Differ from Double Hormone Receptor Positive Breast Cancers?

  • Ng, Char-Hong (Department of Surgery, University Malaya Medical Centre) ;
  • Pathy, Nirmala Bhoo (Julius Center University of Malaya, Faculty of Medicine, University of Malaya) ;
  • Taib, Nur Aishah (Department of Surgery, University Malaya Medical Centre) ;
  • Ho, Gwo-Fuang (Oncology and Radiotherapy Unit, University Malaya Medical Centre) ;
  • Mun, Kein-Seong (Department of Pathology, University Malaya Medical Centre) ;
  • Rhodes, Anthony (Department of Pathology, University Malaya Medical Centre) ;
  • Looi, Lai-Meng (Department of Pathology, University Malaya Medical Centre) ;
  • Yip, Cheng-Har (Department of Surgery, University Malaya Medical Centre)
  • Published : 2014.10.11
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Abstract

The significance of the single hormone receptor positive phenotype of breast cancer is still poorly understood. The use of hormone therapy has been found to be less effective for this type, which has a survival outcome midway between double positive and double negative phenotypes. The aim of this study was to investigate differences in patient and tumor characteristics and survival between double-receptor positive (ER+PR+), double receptor negative (ER-PR-) and single receptor positive (ER+PR- and ER-PR+) breast cancer in an Asian setting. A total of 1,992 patients with newly diagnosed stage I to IV breast cancer between 2003 and 2008, and where information on ER and PR were available, were included in this study. The majority of patients had ER+PR+ tumors (n=903: 45.3%), followed by 741 (37.2%) ER-PR-, 247 (12.4%) ER+PR-, and 101 (5.1%) ER-PR+ tumors. Using multivariate analysis, ER+PR- tumors were 2.4 times more likely to be grade 3 compared to ER+PR+ tumors. ER+PR- and ER-PR+ tumors were 82% and 86% respectively less likely to be grade 3 compared with ER-PR- tumors. ER-PR+ tumours were associated with younger age. There were no survival differences between patients with ER+PR+ and ER-PR+ tumors. However, ER+PR- tumors have poorer survival compared with ER+PR+ tumours. ER-PR- tumours had the worst survival. Adjuvant hormonal therapy with tamoxifen was found to have identical survival advantage in patients with ER+PR+ and ER-PR+ tumors whereas impact was slightly lower in patients with ER+PR- tumors. In conclusion, we found ER+PR- tumors to be more aggressive and have poorer survival when compared to ER+PR+ tumors, while patients with ER-PR+ tumours were younger, but had a similar survival to their counterparts with ER+PR+ tumours.

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References

  1. Bardou VJ, Arpino G, Elledge RM, et al (2003). Progesterone receptor status significantly improves outcome prediction over estrogen receptor status alone for adjuvant endocrine therapy in two large breast cancer databases. J Clin Oncol, 21, 1973-9. https://doi.org/10.1200/JCO.2003.09.099
  2. Chow LW, Ho P (2000). Hormonal receptor determination of 1,052 Chinese breast cancers. J Surg Oncol, 75, 172-5. https://doi.org/10.1002/1096-9098(200011)75:3<172::AID-JSO4>3.0.CO;2-A
  3. De Maeyer L, Van Limbergen E, De Nys K, et al (2008). Does estrogen receptor negative/progesterone receptor positive breast carcinoma exist? J Clin Oncol, 26, 335-6; author reply 6-8. https://doi.org/10.1200/JCO.2007.14.8411
  4. Dowsett M, Houghton J, Iden C, et al (2006). Benefit from adjuvant tamoxifen therapy in primary breast cancer patients according oestrogen receptor, progesterone receptor, EGF receptor and HER2 status. Ann Oncol, 17, 818-26. https://doi.org/10.1093/annonc/mdl016
  5. Dunnwald LK, Rossing MA, Li CI (2007). Hormone receptor status, tumor characteristics, and prognosis: a prospective cohort of breast cancer patients. Breast Cancer Res, 9, 6.
  6. Hammond ME, Hayes DF, Dowsett M, et al American Society of Clinical Oncology/College Of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol, 28, 2784-95.
  7. Hwang ES, Chew T, Shiboski S, et al (2005). Risk factors for estrogen receptor-positive breast cancer. Arch Surg, 140, 58-62. https://doi.org/10.1001/archsurg.140.1.58
  8. Jasani B, Douglas-Jones A, Rhodes A, et al (2006). Measurement of estrogen receptor status by immunocytochemistry in paraffin wax sections. Methods Mol Med, 120, 127-46.
  9. Khoury T, Sait S, Hwang H, et al (2009). Delay to formalin fixation effect on breast biomarkers. Mod Pathol, 22, 1457-67. https://doi.org/10.1038/modpathol.2009.117
  10. Nadji M (2008). Quantitative immunohistochemistry of estrogen receptor in breast cancer: “much ado about nothing!”. Appl Immunohistochem Mol Morphol, 16, 105-7. https://doi.org/10.1097/PAI.0b013e3181607323
  11. Nadji M, Gomez-Fernandez C, Ganjei-Azar P, et al (2005). Immunohistochemistry of estrogen and progesterone receptors reconsidered: experience with 5,993 breast cancers. Am J Clin Pathol, 123, 21-7. https://doi.org/10.1309/4WV79N2GHJ3X1841
  12. Ng CH, Pathy NB, Taib NA, et al (2012). The estrogen receptor negative-progesterone receptor positive breast carcinoma is a biological entity and not a technical artifact. Asian Pac J Cancer Prev, 13, 1111-3. https://doi.org/10.7314/APJCP.2012.13.4.1111
  13. Pathy NB, Yip CH, Taib NA, et al (2011). Breast cancer in a multi-ethnic Asian setting: results from the Singapore-Malaysia hospital-based breast cancer registry. Breast, 20, 75-80.
  14. Rakha EA, El-Sayed ME, Green AR, et al (2007). Biologic and clinical characteristics of breast cancer with single hormone receptor positive phenotype. J Clin Oncol, 25, 4772-8. https://doi.org/10.1200/JCO.2007.12.2747
  15. Rakha EA, Reis-Filho JS, Ellis IO Combinatorial biomarker expression in breast cancer. Breast Cancer Res Treat, 120, 293-308.
  16. Rakha EA, Reis-Filho JS, Ellis IO (2010). Combinatorial biomarker expression in breast cancer. Breast Cancer Res Treat, 120, 293-308. https://doi.org/10.1007/s10549-010-0746-x
  17. Rhodes A, Jasani B (2009). The oestrogen receptor-negative/progesterone receptor-positive breast tumour: a biological entity or a technical artefact? J Clin Pathol, 62, 95-6.
  18. Rhodes A, Jasani B, Balaton AJ, et al (2000). Frequency of oestrogen and progesterone receptor positivity by immunohistochemical analysis in 7016 breast carcinomas:correlation with patient age, assay sensitivity, threshold value, and mammographic screening. J Clin Pathol, 53, 688-96. https://doi.org/10.1136/jcp.53.9.688
  19. Wyss P, Rageth JC, Unger C, et al (1992). [Prognostic and therapeutic significance of steroid receptors in invasive breast cancer]. Geburtshilfe und Frauenheilkunde, 52, 611-6. https://doi.org/10.1055/s-2007-1023194
  20. Yip CH (2009). Breast cancer in Asia. Methods Mol Biol, 471, 51-64. https://doi.org/10.1007/978-1-59745-416-2_3
  21. Yu KD, Di GH, Wu J, et al (2008a). Breast cancer patients with estrogen receptor-negative/progesterone receptor-positive tumors: being younger and getting less benefit from adjuvant tamoxifen treatment. J Cancer Res Clin Oncol, 134, 1347-54. https://doi.org/10.1007/s00432-008-0414-2
  22. Yu KD, Di GH, Wu J, et al (2008b). Breast cancer patients with estrogen receptor-negative/progesterone receptor-positive tumors: being younger and getting less benefit from adjuvant tamoxifen treatment. J Cancer Res Clin Oncol, 134, 1347-54. https://doi.org/10.1007/s00432-008-0414-2
  23. Yu KD, Liu GY, Di GH, et al (2007). Progesterone receptor status provides predictive value for adjuvant endocrine therapy in older estrogen receptor-positive breast cancer patients. Breast, 16, 307-15. https://doi.org/10.1016/j.breast.2006.12.011

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