Abstract
The prognostic value of oestrogen receptor (ER) and progesterone receptor (PR) was estimated through a multicentric study of 2257 operable breast cancer patients followed up for a median of 8.5 years. None of the patients had received adjuvant therapy. The series included 33.3% stage I patients, 57.1% stage II, 5.7% stage IIIa and 2.4% stage IIIb. At the end point of the study 589 metastases and 537 deaths from cancer were recorded. Receptor measurements were performed by radiolgand assay according to a uniform protocol. A total of 68.8% of the tumous were ER positive and 54.0% PR positive ( > or = 10 fmol mg-1 cytosol protein). In univariate analysis, ER and PR status (positive/negative) were of prognostic value (P < 0.001) for the disease-free interval (DFI), the metastases-free interval (MFI) and the overall survival (OS). The OS of the patients after a first metastasis was also significantly different between ER-positive and -negative tumours (P < 0.001). In multivariate analysis (Cox proportional hazard model, 1665 patients), only the ER status showed a significant difference (P < 0.01) between positive and negative groups regarding the DFI, MFI and OS. By using Cox non-proportional, time-dependent models, we show that the predictive value of ER status of the primary tumour decreases by approximately 20% per year, losing its significance after 8 years of follow-up. Overall, when compared with TNM and histological grading, ER and PR status have a low prognostic value, their major interest remaining solely in the domain of therapeutic decision.
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Selected References
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- Aaltomaa S., Lipponen P., Eskelinen M., Kosma V. M., Marin S., Alhava E., Syrjänen K. Hormone receptors as prognostic factors in female breast cancer. Ann Med. 1991 Dec;23(6):643–648. doi: 10.3109/07853899109148097. [DOI] [PubMed] [Google Scholar]
- Adami H. O., Malker B., Holmberg L., Persson I., Stone B. The relation between survival and age at diagnosis in breast cancer. N Engl J Med. 1986 Aug 28;315(9):559–563. doi: 10.1056/NEJM198608283150906. [DOI] [PubMed] [Google Scholar]
- 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]
- Chevallier B., Heintzmann F., Mosseri V., Dauce J. P., Bastit P., Graic Y., Brunelle P., Basuyau J. P., Comoz M., Asselain B. Prognostic value of estrogen and progesterone receptors in operable breast cancer. Results of a univariate and multivariate analysis. Cancer. 1988 Dec 15;62(12):2517–2524. doi: 10.1002/1097-0142(19881215)62:12<2517::aid-cncr2820621211>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
- Clark G. M., Wenger C. R., Beardslee S., Owens M. A., Pounds G., Oldaker T., Vendely P., Pandian M. R., Harrington D., McGuire W. L. How to integrate steroid hormone receptor, flow cytometric, and other prognostic information in regard to primary breast cancer. Cancer. 1993 Mar 15;71(6 Suppl):2157–2162. doi: 10.1002/1097-0142(19930315)71:6+<2157::aid-cncr2820711606>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
- Gelbfish G. A., Davidson A. L., Kopel S., Schreibman B., Gelbfish J. S., Degenshein G. A., Herz B. L., Cunningham J. N. Relationship of estrogen and progesterone receptors to prognosis in breast cancer. Ann Surg. 1988 Jan;207(1):75–79. doi: 10.1097/00000658-198801000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Haybittle J. L., Blamey R. W., Elston C. W., Johnson J., Doyle P. J., Campbell F. C., Nicholson R. I., Griffiths K. A prognostic index in primary breast cancer. Br J Cancer. 1982 Mar;45(3):361–366. doi: 10.1038/bjc.1982.62. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Høst H., Lund E. Age as a prognostic factor in breast cancer. Cancer. 1986 Jun 1;57(11):2217–2221. doi: 10.1002/1097-0142(19860601)57:11<2217::aid-cncr2820571124>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
- Mathiesen O., Bonderup O., Carl J., Panduro J., Pedersen K. O. The prognostic value of estrogen and progesterone receptors in female breast cancer. A single center study. Acta Oncol. 1991;30(6):691–695. doi: 10.3109/02841869109092441. [DOI] [PubMed] [Google Scholar]
- Raemaekers J. M., Beex L. V., Koenders A. J., Pieters G. F., Smals A. G., Benraad T. J., Kloppenborg P. W. Disease-free interval and estrogen receptor activity in tumor tissue of patients with primary breast cancer: analysis after long-term follow-up. Breast Cancer Res Treat. 1985;6(2):123–130. doi: 10.1007/BF02235743. [DOI] [PubMed] [Google Scholar]
- Silvestrini R., Daidone M. G., Luisi A., Boracchi P., Mezzetti M., Di Fronzo G., Andreola S., Salvadori B., Veronesi U. Biologic and clinicopathologic factors as indicators of specific relapse types in node-negative breast cancer. J Clin Oncol. 1995 Mar;13(3):697–704. doi: 10.1200/JCO.1995.13.3.697. [DOI] [PubMed] [Google Scholar]
- Spyratos F., Hacene K., Tubiana-Hulin M., Pallud C., Brunet M. Prognostic value of estrogen and progesterone receptors in primary infiltrating ductal breast cancer. A sequential multivariate analysis of 1262 patients. Eur J Cancer Clin Oncol. 1989 Aug;25(8):1233–1240. doi: 10.1016/0277-5379(89)90420-3. [DOI] [PubMed] [Google Scholar]
- Stål O., Carstensen J., Hatschek T., Nordenskjöld B. Significance of S-phase fraction and hormone receptor content in the management of young breast cancer patients. Br J Cancer. 1992 Oct;66(4):706–711. doi: 10.1038/bjc.1992.342. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- Todd J. H., Dowle C., Williams M. R., Elston C. W., Ellis I. O., Hinton C. P., Blamey R. W., Haybittle J. L. Confirmation of a prognostic index in primary breast cancer. Br J Cancer. 1987 Oct;56(4):489–492. doi: 10.1038/bjc.1987.230. [DOI] [PMC free article] [PubMed] [Google Scholar]