Change in the oestrogen receptor status of breast cancer with age – comparison of two types of assay

Abstract

Summary The oestrogen receptor (ER) is considered to be an essential component of the mechanism of response of a breast tumour to endocrine therapy, but ER measurements have proved to have only modest predictive value. In the present study, we have examined ER status by both immunocytochemical assay (ER-ICA) on a fine needle aspirate and by radioligand-binding assay (DCC) on an excised portion of tumour.There was a correlation between the ER level detected by the two assays (Spearman's r = 0.77 for DCC versus ER-ICA staining intensity, r = 0.70 for DCC versus ER-ICA percentage of cells stained, P< 0.0001, n = 137 in each case). Each assay showed an increasing proportion of ER + ve results with increasing patient age. In the case of ER + ve tissues only, while ER concentration by DCC assay increased steadily with age (r = 0.39, P <0.0001, n = 108), the ER-ICA assay revealed that, staining intensity increased with age (r = 0.26, P = 0.001, n = 149) but the percentage of cells stained did not (r = 0.08, P = NS, n = 149).It is concluded that increasing endocrine responsiveness with advancing age could reflect the increasing proportion of ER + ve tumours with increased levels of ER per cell (as indicated by staining intensity) rather than increasing proportion of ER + ve cells.Response to endocrine therapy depends, to a large extent, on the presence or absence of oestrogen receptors (Lippman & Allegra 1980;Manni et al., 1980;Furr & Jordan, 1984;Hawkins 1985;Oriana et al., 1987). In addition, response and oestrogen receptor status have both been reported to change with age (Patterson et al., 1981;Beex & Koenders, 1984 (Hawkins et al., 1975(Hawkins et al., , 1981

Pathobiological features of breast tumours in the State of Kuwait: a comprehensive analysis

“…Ferno et al [ 19 ] reported a lower expression of ER in patients below 50 years old, and Quong et al [ 20 ] found that the expression of ER by breast carcinomas increases with age. Similar findings to Quong were observed by Holdaway and Mountjoy [ 21 ], Clark et al [ 22 ], Wilking et al [ 23 ], Gaskell et al [ 24 ], Rhodes et al [ 25 ], and Tominaga et al [ 26 ]. Other studies have, however, found no association between the age of the patient and the degree of expression of ER by the tumour [ 27 ].…”

The aged breast

“…Most studies have found that there is a higher frequency of ER‐positive cancers in the older age group (Table 2), range 80–90% 35–38, 57–59, with a parallel higher figure for PgR 35–38. Different approaches have been used for assessing: proliferation—S‐phase fraction 36, 60; thymidine labelling index 35; Ki‐67/MIB1 immunohistochemistry 37, 38, 61.…”