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. 1993 Jul;218(1):13–21. doi: 10.1097/00000658-199307000-00004

Immunohistochemical and biochemical measurement of estrogen and progesterone receptors in primary breast cancer. Correlation of histopathology and prognostic factors.

M Stierer 1, H Rosen 1, R Weber 1, H Hanak 1, J Spona 1, H Tüchler 1
PMCID: PMC1242895  PMID: 8328824

Abstract

OBJECTIVE: The authors investigated correlations of estrogen-receptor and progesterone-receptor with conventional risk factors as well as histopathology in patients with primary breast cancer. SUMMARY BACKGROUND DATA: Immunohistochemically determined hormone receptors have gained importance as prognosticators in primary breast cancer, but their definitive role has not yet been evaluated. METHODS: Tumor samples from 299 patients were examined for estrogen and progesterone receptors by biochemical and immunohistochemical assay. Correlations with established risk factors (tumor size, lymph node status, menopausal status, grading including subfactors) and histopathology were analyzed. RESULTS: The estrogen receptor, determined by immunohistochemical method revealed positivity in 80.6% of patients; biochemical measurement yielded 76.2% positive results. The progesterone receptor measured by immunohistochemistry yielded 61.3% positivity versus 55.8% detected by biochemical analysis. Invasive lobular, tubular, and ductal invasive carcinoma with prominent stroma content ("scirrhous carcinoma") rather than ductal invasive carcinoma was more frequently estrogen-receptor positive with immunohistochemistry than with biochemical assay. For progesterone receptor, the same pattern of positivity was seen with immunohistochemical assay. With progesterone receptor determined biochemically, "scirrhous" and lobular carcinoma showed positive results in a lower proportion than invasive ductal and tubular carcinoma. Significant correlations were observed between the estrogen-receptor status, the histologic grade of malignancy, nuclear polymorphism, and the rate of mitosis with both methods (p < 0.001 respectively). Different correlations were found between tumor size, menopausal status and estrogen receptor status with both assays respectively. For the progesterone receptor status, immunohistochemistry yielded significant correlations with the histologic grade of malignancy, nuclear polymorphism, rate of mitosis (p < 0.001 respectively) as well as growth pattern (p < 0.01), while biochemical analysis revealed a correlation with nuclear polymorphism (p < 0.05). The correlation analysis of both components of the immunoreactive score revealed a more significant impact of percentage of positive cells than of staining intensity. CONCLUSIONS: Immunohistochemistry detected a closer correlation between prognostic factors and receptor data than biochemical analysis.

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Selected References

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  1. Antoniades K., Spector H. Correlation of estrogen receptor levels with histology and cytomorphology in human mammary cancer. Am J Clin Pathol. 1979 May;71(5):497–503. doi: 10.1093/ajcp/71.5.497. [DOI] [PubMed] [Google Scholar]
  2. BLOOM H. J., RICHARDSON W. W. Histological grading and prognosis in breast cancer; a study of 1409 cases of which 359 have been followed for 15 years. Br J Cancer. 1957 Sep;11(3):359–377. doi: 10.1038/bjc.1957.43. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Berger U., McClelland R. A., Wilson P., Greene G. L., Haussler M. R., Pike J. W., Colston K., Easton D., Coombes R. C. Immunocytochemical determination of estrogen receptor, progesterone receptor, and 1,25-dihydroxyvitamin D3 receptor in breast cancer and relationship to prognosis. Cancer Res. 1991 Jan 1;51(1):239–244. [PubMed] [Google Scholar]
  4. Butler J. A., Bretsky S., Menendez-Botet C., Kinne D. W. Estrogen receptor protein of breast cancer as a predictor of recurrence. Cancer. 1985 Mar 15;55(6):1178–1181. doi: 10.1002/1097-0142(19850315)55:6<1178::aid-cncr2820550606>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  5. Clark G. M., Osborne C. K., McGuire W. L. Correlations between estrogen receptor, progesterone receptor, and patient characteristics in human breast cancer. J Clin Oncol. 1984 Oct;2(10):1102–1109. doi: 10.1200/JCO.1984.2.10.1102. [DOI] [PubMed] [Google Scholar]
  6. Fisher E. R., Redmond C. K., Liu H., Rockette H., Fisher B. Correlation of estrogen receptor and pathologic characteristics of invasive breast cancer. Cancer. 1980 Jan 15;45(2):349–353. doi: 10.1002/1097-0142(19800115)45:2<349::aid-cncr2820450226>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  7. Greene G. L., Fitch F. W., Jensen E. V. Monoclonal antibodies to estrophilin: probes for the study of estrogen receptors. Proc Natl Acad Sci U S A. 1980 Jan;77(1):157–161. doi: 10.1073/pnas.77.1.157. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kinne D. W., Butler J. A., Kimmel M., Flehinger B. J., Menendez-Botet C., Schwartz M. Estrogen receptor protein of breast cancer in patients with positive nodes. High recurrence rates in the postmenopausal estrogen receptor-negative group. Arch Surg. 1987 Nov;122(11):1303–1306. doi: 10.1001/archsurg.1987.01400230089016. [DOI] [PubMed] [Google Scholar]
  9. Knight W. A., Livingston R. B., Gregory E. J., McGuire W. L. Estrogen receptor as an independent prognostic factor for early recurrence in breast cancer. Cancer Res. 1977 Dec;37(12):4669–4671. [PubMed] [Google Scholar]
  10. Kohail H. M., Elias E. G., el-Nowiem S. A., Bashirelahi N., Didolkar M. S., Reed W. P. A multifactorial analysis of steroid hormone receptors in stages I and II breast cancer. Ann Surg. 1985 May;201(5):611–617. doi: 10.1097/00000658-198505000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Le Doussal V., Tubiana-Hulin M., Friedman S., Hacene K., Spyratos F., Brunet M. Prognostic value of histologic grade nuclear components of Scarff-Bloom-Richardson (SBR). An improved score modification based on a multivariate analysis of 1262 invasive ductal breast carcinomas. Cancer. 1989 Nov 1;64(9):1914–1921. doi: 10.1002/1097-0142(19891101)64:9<1914::aid-cncr2820640926>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  12. Lesser M. L., Rosen P. P., Senie R. T., Duthie K., Menendez-Botet C., Schwartz M. K. Estrogen and progesterone receptors in breast carcinoma: correlations with epidemiology and pathology. Cancer. 1981 Jul 15;48(2):299–309. doi: 10.1002/1097-0142(19810715)48:2<299::aid-cncr2820480215>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
  13. Mohammed R. H., Lakatua D. J., Haus E., Yasmineh W. J. Estrogen and progesterone receptors in human breast cancer. Correlation with histologic subtype and degree of differentiation. Cancer. 1986 Sep 1;58(5):1076–1081. doi: 10.1002/1097-0142(19860901)58:5<1076::aid-cncr2820580516>3.0.co;2-m. [DOI] [PubMed] [Google Scholar]
  14. Nicholson R. I., Campbell F. C., Blamey R. W., Elston C. W., George D., Griffiths K. Steroid receptors in early breast cancer: value in prognosis. J Steroid Biochem. 1981 Dec;15:193–199. doi: 10.1016/0022-4731(81)90275-2. [DOI] [PubMed] [Google Scholar]
  15. Osborne C. K., Yochmowitz M. G., Knight W. A., 3rd, McGuire W. L. The value of estrogen and progesterone receptors in the treatment of breast cancer. Cancer. 1980 Dec 15;46(12 Suppl):2884–2888. doi: 10.1002/1097-0142(19801215)46:12+<2884::aid-cncr2820461429>3.0.co;2-u. [DOI] [PubMed] [Google Scholar]
  16. Parl F. F., Wagner R. K. The histopathological evaluation of human breast cancers in correlation with estrogen receptor values. Cancer. 1980 Jul 15;46(2):362–367. doi: 10.1002/1097-0142(19800715)46:2<362::aid-cncr2820460225>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  17. Perrot-Applanat M., Logeat F., Groyer-Picard M. T., Milgrom E. Immunocytochemical study of mammalian progesterone receptor using monoclonal antibodies. Endocrinology. 1985 Apr;116(4):1473–1484. doi: 10.1210/endo-116-4-1473. [DOI] [PubMed] [Google Scholar]
  18. Pertschuk L. P., Feldman J. G., Eisenberg K. B., Carter A. C., Thelmo W. L., Cruz W. P., Thorpe S. M., Christensen I. J., Rasmussen B. B., Rose C. Immunocytochemical detection of progesterone receptor in breast cancer with monoclonal antibody. Relation to biochemical assay, disease-free survival, and clinical endocrine response. Cancer. 1988 Jul 15;62(2):342–349. doi: 10.1002/1097-0142(19880715)62:2<342::aid-cncr2820620219>3.0.co;2-1. [DOI] [PubMed] [Google Scholar]
  19. Pertschuk L. P., Kim D. S., Nayer K., Feldman J. G., Eisenberg K. B., Carter A. C., Rong Z. T., Thelmo W. L., Fleisher J., Greene G. L. Immunocytochemical estrogen and progestin receptor assays in breast cancer with monoclonal antibodies. Histopathologic, demographic, and biochemical correlations and relationship to endocrine response and survival. Cancer. 1990 Oct 15;66(8):1663–1670. doi: 10.1002/1097-0142(19901015)66:8<1663::aid-cncr2820660802>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  20. Poulsen H. S., Ozzello L., Andersen J. Oestrogen receptors in human breast cancer. Problems of correlation with histopathological features. Virchows Arch A Pathol Anat Histol. 1982;397(1):103–108. doi: 10.1007/BF00430897. [DOI] [PubMed] [Google Scholar]
  21. Rank F., Dombernowsky P., Jespersen N. C., Pedersen B. V., Keiding N. Histologic malignancy grading of invasive ductal breast carcinoma. A regression analysis of prognostic factors in low-risk carcinomas from a multicenter trial. Cancer. 1987 Sep 15;60(6):1299–1305. doi: 10.1002/1097-0142(19870915)60:6<1299::aid-cncr2820600623>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
  22. Reiner A., Neumeister B., Spona J., Reiner G., Schemper M., Jakesz R. Immunocytochemical localization of estrogen and progesterone receptor and prognosis in human primary breast cancer. Cancer Res. 1990 Nov 1;50(21):7057–7061. [PubMed] [Google Scholar]
  23. Reiner A., Reiner G., Spona J., Schemper M., Holzner J. H. Histopathologic characterization of human breast cancer in correlation with estrogen receptor status. A comparison of immunocytochemical and biochemical analysis. Cancer. 1988 Mar 15;61(6):1149–1154. doi: 10.1002/1097-0142(19880315)61:6<1149::aid-cncr2820610615>3.0.co;2-z. [DOI] [PubMed] [Google Scholar]
  24. Remmele W., Stegner H. E. Vorschlag zur einheitlichen Definition eines Immunreaktiven Score (IRS) für den immunhistochemischen Ostrogenrezeptor-Nachweis (ER-ICA) im Mammakarzinomgewebe. Pathologe. 1987 May;8(3):138–140. [PubMed] [Google Scholar]
  25. Rosen H. R., Stierer M., Weber R. Nuclear polymorphism--a prognostic parameter to evaluate local recurrence of female breast cancer. Breast Cancer Res Treat. 1990 Nov;17(1):9–13. doi: 10.1007/BF01812679. [DOI] [PubMed] [Google Scholar]
  26. Rosen P. P., Menendez-Botet C. J., Nisselbaum J. S., Urban J. A., Miké V., Fracchia A., Schwartz M. K. Pathological review of breast lesions analyzed for estrogen receptor protein. Cancer Res. 1975 Nov;35(11 Pt 1):3187–3194. [PubMed] [Google Scholar]
  27. Saez S., Cheix F., Asselain B. Prognostic value of estrogen and progesterone receptors in primary breast cancer. Breast Cancer Res Treat. 1983;3(4):345–353. doi: 10.1007/BF01807587. [DOI] [PubMed] [Google Scholar]
  28. Samaan N. A., Buzdar A. U., Aldinger K. A., Schultz P. N., Yang K. P., Romsdahl M. M., Martin R. Estrogen receptor: a prognostic factor in breast cancer. Cancer. 1981 Feb 1;47(3):554–560. doi: 10.1002/1097-0142(19810201)47:3<554::aid-cncr2820470322>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
  29. Shapiro C. M., Schifeling D., Bitran J. D., Desser R. K., Rochman H., Michel A., Shapiro R., Evans R., Kozloff M. F., Recant W. Prognostic value of the estrogen receptor level in pathologic stage I and II adenocarcinoma of the breast. J Surg Oncol. 1982 Feb;19(2):119–121. doi: 10.1002/jso.2930190216. [DOI] [PubMed] [Google Scholar]
  30. Stierer M., Rosen H. R., Weber R., Marczell A., Kornek G. V., Czerwenka E. Long term analysis of factors influencing the outcome in carcinoma of the breast smaller than one centimeter. Surg Gynecol Obstet. 1992 Aug;175(2):151–160. [PubMed] [Google Scholar]
  31. Stierer M., Rosen H., Weber R. Nuclear pleomorphism, a strong prognostic factor in axillary node-negative small invasive breast cancer. Breast Cancer Res Treat. 1992 Jan;20(2):109–116. doi: 10.1007/BF01834640. [DOI] [PubMed] [Google Scholar]
  32. Thoresen S., Tangen M., Støa K. F., Hartveit F. Oestrogen receptor values and histological grade in human breast cancer. Histopathology. 1981 May;5(3):257–262. doi: 10.1111/j.1365-2559.1981.tb01784.x. [DOI] [PubMed] [Google Scholar]
  33. Thorpe S. M., Rose C., Rasmussen B. B., Mouridsen H. T., Bayer T., Keiding N. Prognostic value of steroid hormone receptors: multivariate analysis of systemically untreated patients with node negative primary breast cancer. Cancer Res. 1987 Nov 15;47(22):6126–6133. [PubMed] [Google Scholar]
  34. Walker K. J., Bouzubar N., Robertson J., Ellis I. O., Elston C. W., Blamey R. W., Wilson D. W., Griffiths K., Nicholson R. I. Immunocytochemical localization of estrogen receptor in human breast tissue. Cancer Res. 1988 Nov 15;48(22):6517–6522. [PubMed] [Google Scholar]

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