The value of estrogen receptor (ER) measurements for predicting recurrence and survival rates in primary breast cancer was examined in 121 women who were followed from 5 to 12 years after mastectomy with a median follow‐up of 64 months. The prognostic significance of the ER status was evaluated independently and in association with tumor stage, axillary node metastasis, and histopathologic grade. The independent evaluation demonstrated no statistically significant difference in prognosis between women with ER‐negative and ER‐positive cancers, although the latter group tended to have a longer time to recurrence and longer survival. Multivariate analysis of the data by Cox's proportional hazard regression techniques revealed a synergistic effect of ER status on the risk associated with axillary node metastasis. Patients with nodal metastasis were at 2.8 times the risk of recurrence compared to patients without metastasis. For women with nodal metastasis whose primary cancer was ER‐negative, this risk increased to 4.6 times compared to women without metastasis and ER‐positive tumors (P = 0.0003). The risk of cancer‐related death was 5.6 times more likely for poorly differentiated tumors than for highly differentiated tumors. Patients with poorly differentiated ER‐negative tumors were at an even higher risk (7.0) of dying than women with highly differentiated ER‐positive carcinomas (P = 0.009). In conjunction with tumor stage, axillary node metastasis and histopathologic grade ER determination is useful for identifying subpopulations at increased risk of tumor recurrence or mortality.

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A detailed histopathological review of 140 primary breast cancers analyzed for estrogen receptor protein (ERP) was carried out and a variety of morphological features correlated with ERP results. ERP in cytosols was incubated with [3H]estradiol in the presence and absence of cold estradiol and assayed by agargel electrophoresis. Tumors binding greater than 10 fmol estradiol/mg tissue protein were classified as receptor-positive. Seventy-seven percent of the 116 infiltrating duct carcinomas were ERP-positive. The well-differentiated tumors of this group had a higher incidence of ERP-positivity than the poorly differentiated ones. The ten predominantly or exclusively intraductal carcinomas and the seven medullary tumors were less frequently positive than the main group of infiltrating ductal cancers. The three colloid, two tubular, and two lobular carcinomas in this series were all ERP-positive. When receptor measurements are evaluated, consideration should be given to the degree of differentiation and the histological type of tumor, in addition to other factors known to influence receptor levels such as menopausal status and seasonal variation.

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Human mammary gland and tumours derived from it contain individual receptors for oestradiol1) and for dihydrotestosterone. Analysis of 97 mammary cancers by agargel electrophoresis revealed a widely varying pattern of simultaneous occurrence in different concentration ratios (46), sole presence of oestradiol receptor (23) or dihydrotestosterone receptor (8) and absence of both receptors (18). The relevance of the results is discussed and the need for an extensive cooperative study is emphasized.The full course of action of all steroid hormones includes characteristic en¬ hancements of transcription. Mediators are intracellular proteins, so-called re¬ ceptors, which bind their respective steroids with high affinity and specificity. The presence of receptors in cells is therefore regarded as an indicator of their hormone-responsiveness. This rationale has been first applied to medicine through the assay of oestradiol receptor in mammary cancers (Jensen et al. 1967). Several investigators reported a positive correlation between oestradiol receptor content and the success of certain endocrine treatments (Jensen et al.A preliminary report was given at the 19.