Does Estrogen Receptor–Negative/Progesterone Receptor–Positive Breast Carcinoma Exist?

Maeyer, L. De; Limbergen, Erik; Nys, Katelijne De; Moerman, Philippe; Pochet, Nathalie; Hendrickx, Wouter; Wildiers, Hans; Paridaens, Robert; Smeets, Ann; Christiaens, Marie Rose; Vergote, Ignace; Leunen, Karin; Amant, Frédéric; Neven, Patrick

doi:10.1200/jco.2007.14.8411

Cited by 93 publications

(73 citation statements)

References 9 publications

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“…Misclassification of ER and PR tumor marker status may have resulted because of the use of IHC method, used by most of our contributing laboratories, which has been reported to have limited specificity [80].…”

Section: Resultsmentioning

confidence: 99%

Tumor marker phenotype concordance in second primary breast cancer, California, 1999–2004

Brown

Bauer

Pare

2009

Breast Cancer Res Treat

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Breast cancer is the most common cancer among women. It is estimated that 7% of women who have breast cancer will develop a subsequent second independent breast tumor within 10 years of the first. The status of estrogen (ER), progesterone (PR) and human growth hormone (HER2) receptors, individually and as phenotypic combinations, impacts the clinical course of breast cancer and may impact the course of subsequent primary tumors and patient survival. Our aims were to determine tumor marker phenotype concordance between first and second primary breast cancers (FPBC and SPBC), describe demographic and clinical characteristics, and examine first tumor treatments associated with phenotype concordance. A total of 76,209 cases of female invasive breast cancer were identified in the California Cancer Registry from 1999 to 2004. Of those, 1,407 women who had not undergone a prophylactic mastectomy, had information on the status of three tumor markers, and were diagnosed with an SPBC during the study period were selected. SPBCs were significantly smaller, diagnosed at a higher stage and were node positive. Patients whose FPBC was ER(+)/-/PR(+)/-/HER2- and triple negative (TN) (ER-/PR-/HER2-), often had concordant phenotypes for their SPBC. ER(+)/-/PR(+)/-/HER2+ and HER2-positive (ER-/PR-/HER2+) FPBCs, often had discordant phenotypes for their SPBC. ER(+)/-/PR(+)/-/HER2- SPBCs often lacked HER2 expression and were ER and/or PR positive. Tumor laterality and synchronicity significantly predicted concordance as did having a FPBC whose phenotypes were ER(+)/-/PR(+)/-/HER2+, HER2-positive and TN, while first primary tumor treatment with chemotherapy predicted discordance. The relationship between multiple primary breast cancer phenotype concordance and patient prognosis has yet to be determined. Our results indicate that SPBC surveillance strategies include consideration of FPBC phenotype. Although our results are provocative, they may have been influenced by current criteria used to determine tumor independence.

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Section: Resultsmentioning

confidence: 99%

Tumor marker phenotype concordance in second primary breast cancer, California, 1999–2004

Brown

Bauer

Pare

2009

Breast Cancer Res Treat

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“…It should be emphasised that it can be difficult to ascertain the true clinical significance of the ER-PR+ phenotype, when analysing a retrospective series of cases. (Ng et al, 2012) It only presents in a small number of cases (1-10%) and indeed re-testing of cases by some authors utilising more sensitive immunohistochemical detection systems and lower cut points suggests that at least some of these cases are double receptor positive using alternative assessment criteria (Hammond et al; Nadji et al, 2005;De Maeyer et al, 2008;Nadji, 2008). In addition hormone receptors are notoriously labile and unless tissues are fixed promptly and the cold ischaemia time between surgical removal and immersion in fixative is kept to a minimum, there is the confounding factor of receptor degradation and consequent false negative assay results (Khoury et al, 2009) All these factors need to be taken into consideration when considering the clinical relevance of the ER-PR+ result.…”

Section: Discussionmentioning

confidence: 99%

“…Cold ischaemia time, that is, the interval between surgical removal of the breast and fixation in formalin, leads to degradation of the labile ER and PR receptors, and the ER may be more labile than PR, and hence could degrade more readily than PR. Hence, a proportion of ER-PR+ tumors may be actually be ER+PR+ because of delayed tissue fixation or technical failure of the IHC assay (Rhodes et al, 2000;Nadji et al, 2005;Jasani et al, 2006;De Maeyer et al, 2008;Nadji, 2008). If this is true, then it would be expected that the ER-PR+ phenotype would have similar tumor characteristics to the ER+PR+ phenotype.…”

Section: Introductionmentioning

confidence: 99%

Do Clinical Features and Survival of Single Hormone Receptor Positive Breast Cancers Differ from Double Hormone Receptor Positive Breast Cancers?

Bhoo-Pathy²,

Taib³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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The significance of the single hormone receptor positive phenotype of breast cancer is still poorly understood. The use of hormone therapy has been found to be less effective for this type, which has a survival outcome midway between double positive and double negative phenotypes. The aim of this study was to investigate differences in patient and tumor characteristics and survival between double-receptor positive (

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“…[27] Shen et al in their study analysed 5374 consecutive breast cancer cases and concluded ER negative/PR positive as a definite subset group of breast cancer cases constituting 2.3% of the total number of cases. [28] Zhu et al in their study at relapse of primary to metastatic lesion in breast carcinoma found that the rate of gain of ER and PR positivity were 10.9 and 13.5% respectively; the rates of loss of ER and PR positivity were 23.3 and 24.9%.…”

Section: Discussionmentioning

confidence: 99%

Hormone Receptor Status of Breast Cancer in Northern Region of India- A Study

Arundhati¹,

Anupama²

2017

jemds

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Does Estrogen Receptor–Negative/Progesterone Receptor–Positive Breast Carcinoma Exist?

Cited by 93 publications

References 9 publications

Tumor marker phenotype concordance in second primary breast cancer, California, 1999–2004

Tumor marker phenotype concordance in second primary breast cancer, California, 1999–2004

Do Clinical Features and Survival of Single Hormone Receptor Positive Breast Cancers Differ from Double Hormone Receptor Positive Breast Cancers?

Hormone Receptor Status of Breast Cancer in Northern Region of India- A Study

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