The long term prognostic significance of oestrogen receptor analysis in early carcinoma of the breast

Abstract

Oestrogen receptors were one of the first molecular markers of prognosis to be described in breast cancer and 10 years ago we reported our experience of their significance in predicting early recurrence of disease following surgical treatment (Cooke et al., 1979). In that study we found the presence of oestrogen receptors to be associated with both longer disease free interval and overall survival. Although our results were similar to those of several other studies (Knight et al., 1977;Allegra et al., 1979;Westerberg et al., 1980;Gapinski et al., 1980), the finding in. some later studies were inconsistent and areas of controversy have arisen. A minority of investigators failed to find any survival advantage for oestrogen receptor positive patients (Hilf et al., 1980;Alanko et al., 1984;Parl et al., 1984). In those studies in which a survival advantage has been reported for patients with oestrogen receptor positive tumours three broad areas of disagreement have emerged. These have related to the duration of time over which oestrogen receptors exert any beneficial effect, the sub-groups of patients benefiting and whether the apparently longer survival of oestrogen receptor positive patients was due to a prolonged disease free survival or longer post recurrence survival.As studies with longer follow-up than in the initial reports appeared the apparent improvement in survival amongst receptor positive patients in some studies was only present for a limited period, thereafter the survival of the two groups being similar (Raemaekers et al., 1985;Von Maillot et al., 1982;Hahnel et al., 1979; Howat et al., 1983). Although some studies found that both disease free interval and overall prognosis were prolonged in receptor positive patients (Bishop et al., 1979;Osborne et al., 1980;Rich et al., 1978) others only noted an improvement in post-relapse survival (Hahnel et al., 1979; Hilf et al., 1980; Howell et al., 1984)

Quantitative histopathology in lymph node-negative breast cancer. Prognostic significance of mitotic counts

“…Measured with greater accuracy, this variable is of well-established and important prognostic significance [28,29]. The missing prognostic value of ER status is in agreement with some [29,42], but in conflict with other reports [13], whereas the association between ER status and histological grade has been recognized previously [27,42]. Most surprisingly, no prognostic value of histological grade was seen, although the morphological evaluation was performed by observers experienced in breast pathology.…”

Prepubertal exposure to zearalenone or genistein reduces mammary tumorigenesis

“…Breast tumours containing ER levels ≥ 5 fmol mg -1 protein are often considered ER-positive (Clark and McGuire, 1988;Winstanley et al, 1991). Using this cutoff point the data indicate that the proportion of ER-positive glands was significantly higher in the zearalenone-treated group (43%) than in the genistein-(14%) or vehicle-treated (28%) groups (χ 2 = 17.80, df = 2, P < 0.01).…”

Higher expression of human kallikrein 10 in breast cancer tissue predicts tamoxifen resistance

“…It is well documented that ER-negative tumours grow more aggressively and tend to metastasise more than ER-positive tumours (Andry et al, 1989;Winstanley et al, 1991). It is possible that hK10, a serine protease, may be associated with aggressiveness and metastatic potential of tumour cells.…”