Proportion of estrogen or progesterone receptor expressing cells in breast cancers and response to endocrine therapy |
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| Affiliation: | 1. Research Team for Geriatric Pathology, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaecho, Itabashi-ku, Tokyo 173-0015, Japan;2. Department of Pathology, Cancer Institute, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan;3. Breast Oncology Center, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan;4. Department of Target Therapy Oncology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan;5. Department of Pathology and Laboratory Medicine, University of Texas Medical School at Houston, 6431 Fannin, MSB 2.270, Houston, TX 77030, USA;6. Breast Medical Oncology, Breast Oncology Center, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo 135-8550, Japan;1. Department of Radiation Oncology, Washington University School of Medicine, Saint Louis, MO;2. Department of Surgery, Washington University School of Medicine, Saint Louis, MO;3. Department of Medicine, Washington University School of Medicine, Saint Louis, MO;4. Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO;1. Division of Medical Senology, European Institute of Oncology, Milan, Italy;2. Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy;3. Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy;4. Division of Pathology and Laboratory Medicine, European Institute of Oncology and University of Milan, Italy;5. Integrated Breast Surgery Unit, European Institute of Oncology and University of Milan, Italy;6. Division of Senology, European Institute of Oncology, Milan, Italy;7. Division of Radiation Oncology, European Institute of Oncology, Milan, Italy;8. Department of Medicine, European Institute of Oncology, Milan, Italy;1. Department of Surgery, “Virgen de la Arrixaca” University Hospital, 30120 Murcia, Spain;2. Department of Statistics, FFIS-IMIB, Luis Fontes Pagán, 9, 1ª Planta, 30120 Murcia, Spain;3. Department of Pathology, Hospital of Xátiva, Crtra de Xàtiva a Silla, Km 1, Valencia, Spain;4. Department of Nuclear Medicine, University Hospital, Hijos de Santiago Rodriguez, 16, 09002 Burgos, Spain;5. Department of Surgery, Complejo Hospitalario de Navarra, La Arboleda, 4, Cizur Menor, 31190 Pamplona, Spain;6. Department of Pathology, University Hospital Txagorritxu, Jose Atxotegui s/n, 01009 Vitoria, Spain;7. Department of Surgery, Fundación Instituto Valenciano de Oncología, Prof. Beltrán Báguena, 8, 46009 Valencia, Spain;1. Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD;2. Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD;1. Department of Otorhinolaryngology Head and Neck Surgery, Affiliated Hospital of Nantong University, Nantong, Jiangsu Province, China;2. Department of Otorhinolaryngology Head and Neck Surgery, The Third People''s Hospital of Nantong, Nantong, Jiangsu Province, China;1. Community Oncology Department, National Cancer Control Programme (NCCP), Dublin, Ireland;2. Post-Graduate Department, Graduate Entry Medical School, University of Limerick, Limerick, Ireland;3. Department of Medical Oncology, University Hospital Limerick, Limerick, Ireland;4. Stokes Institute, University of Limerick, Limerick, Ireland;5. Department of Surgery, University Hospital Limerick, Limerick, Ireland |
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| Abstract: | Immunohistochemical determination of ER/PR status has been the gold standard in clinical practice of breast cancer for decades. A cut-off of ‘1%’ is commonly used; however, this is not supported by strict evidence. How the proportion of ER/PR-positive cells influences the response to endocrine therapy has been scarcely reported, either. To address these issues, 486 and 663 invasive breast cancer cases treated with or without adjuvant tamoxifen respectively (median follow-up period, 12.8 years) were enrolled, and effect of tamoxifen treatment was compared among ER/PR-positive or -negative groups immunohistochemically determined using various cut-offs. Tamoxifen significantly improved 5 years disease-free survival in ER/PR-positive, but not in ER/PR-negative, cases even using immunohistochemical >0% cut-off. Cases with ≥67% ER/PR expressing cells responded to tamoxifen by far the best. Patients having tumors without any ER/PR-positive cells should be excluded from endocrine therapy, whereas this therapy should be strongly recommended for those with ≥67% ER/PR-positive cells. |
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| Keywords: | Breast cancer Estrogen receptor Progesterone receptor Immunohistochemistry Cut-off Endocrine therapy |
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