It Is Not Time to Stop Progesterone Receptor Testing in Breast Cancer

Colomer, Ramón; Beltran, M.; Dorcas, James B.; Cortés, Javier; Hornedo, Javier; Valentín, Vicente; Vargas, Carmela; Mendiola, C.; Ciruelos, Eva

doi:10.1200/jco.2005.05.203

Cited by 39 publications

(28 citation statements)

References 4 publications

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“…Previous studies have reported an estrogen receptornegative, progesterone receptor-positive rate between 1.5 and 10%. 3,20,[34][35][36][37][38][39][40][41][42][43][44] The methods used to determine estrogen and progesterone receptor status varied between these studies, with ligandbinding and laboratory-developed assays predominantly utilized. Of the more recent studies, the range of estrogen receptor-negative, progesterone receptorpositive is 1.5-4.0%; however, almost all of these studies were based on laboratory-developed assays.…”

Section: Discussionmentioning

confidence: 99%

A systematic comparison of three commercial estrogen receptor assays in a single clinical outcome breast cancer cohort

et al. 2016

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Breast cancers are routinely assessed for estrogen receptor status using immunohistochemical assays to assist in patient prognosis and clinical management. Specific assays vary between laboratories, and several antibodies have been validated and recommended for clinical use. As numerous factors can influence assay performance, many laboratories have opted for ready-to-use assays using automated stainers to improve reproducibility and consistency. Three commonly used autostainer vendors-Dako, Leica, and Ventana-all offer such estrogen receptor assays; however, they have never been directly compared. Here, we present a systematic comparison of three platform-specific estrogen receptor ready-to-use assays using a retrospective, tamoxifen-treated, breast cancer cohort from patients who were treated in Calgary, Alberta, Canada from 1985 to 2000. We found all assays showed good intra-observer agreement. Inter-observer pathological scoring showed some variability: Ventana had the strongest agreement followed closely by Dako, whereas Leica only showed substantial agreement. We also analyzed each estrogen receptor assay with respect to 5-year disease-free survival, and found that all performed similarly in univariate and multivariate models. Determination of measures of test performance found that the Leica assay had a lower negative predictive value than Dako or Ventana, compared with the original ligand-binding assay, while other measures-sensitivity, specificity, positive predictive value, and accuracywere comparable between the three ready-to-use assays. When comparing against disease-free survival, the difference in negative predictive value between the vendor assays were not as extreme, but Dako and Ventana still performed slightly better than Leica. Despite some discordance, we found that all ready-to-use assays were comparable with or superior to the ligand-binding assay, endorsing their continued use. Our analysis also allowed for exploration of estrogen receptor-negative, progesterone receptor-positive cases, and we discovered that this phenotype was not consistent across the assays, suggesting this might be an artifact. Endocrine therapy is standard treatment for hormone receptor-positive breast cancers that can improve patient survival. 1-3 Estrogen receptor and progesterone receptor analysis is routinely performed by immunohistochemical assays on breast cancer specimens to classify hormone receptor status and determine patient prognosis and management. [1][2][3][4] Eventually, immunohistochemical-based testing replaced the ligand-binding assay as the standard method for determining hormone receptor status. 5 The switch from ligand-binding assay to immunohistochemistry did not occur at a specific time point, and varied by location and laboratories between the mid-90s and early 2000s. Although estrogen and progesterone receptor are both routinely evaluated, patient management decisions are typically made on the basis of estrogen receptor results alone as the role of progesterone receptor in breast cancer patie...

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Section: Discussionmentioning

confidence: 99%

A systematic comparison of three commercial estrogen receptor assays in a single clinical outcome breast cancer cohort

et al. 2016

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“…The standard IHe biomarkers of ER, PR, and Her2/neu are both prognostic and predictive factors that have been established in multiple studies [40,125, 145,147,163]. The most common subtype, ER+fPR+, have both the best prognosis and the highest rates of response to hormonal therapy [28].…”

Section: Early Invasive Carcinomasmentioning

confidence: 99%

Biologic characteristics of premalignant breast disease

Cole

Tabernero

Anderson

2011

CBM

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Breast cancer is the second leading cause of cancer death in women in the United States. While mammography and breast magnetic resonance imaging (MRI) improve detection of early disease, there remains an Ullmet need for biomarkers for risk stratification, early detection, prediction, and disease prognosis. A number of early breast lesions, from atypical hyperplasias to carcinomas in situ, are associated with an increased risk of developing subsequent invasive breast carcinoma. The recent development of genomic, epigenomic, and proteomic tools for tissue biomarker detection, including array CGH, RNA expression microarrays, and proteomic arrays have identified a number of potential biomarkers that both identify patients at increased risk, as well as provided insights into the pathology of early breast cancer development. This chapter focuses on the detection and application of tissue and serum biomarkers for the identification and risk stratification of early breast cancer lesions.

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“…The value of PR determination in breast cancer has been criticized, because so many cancers show concordant results (i.e. both ER/PR positive or both ER/PR negative) but also strongly supported and the debate on it is still open. In our study, 640 out of 6643 cases showed discordant ER and PR results (9.6%).…”

Section: Discussionmentioning

confidence: 99%

“…Thus, even though the ER is the target of tamoxifen therapy, knowing the status of both hormone receptors may aid in BC clinical management in some cases. However, in the past, the utility of determining the PR status in breast cancer has been both criticized and strongly supported, and the debate is still ongoing. Regardless of its biological significance, the presence of the PR contributes to the classification of a breast tumor.…”

Section: Introductionmentioning

confidence: 99%

ER−/PR+/HER2− breast cancer type shows the highest proliferative activity among all other combined phenotypes and is more common in young patients: Experience with 6643 breast cancer cases

et al. 2019

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The characterization of breast cancer according to its proliferative activity and the expression of estrogen receptors, progesterone receptors, and human epidermal growth factor receptor‐2 is a laboratory routine that has been adopted worldwide for prognostic and therapeutic purposes. By combining data on the expression of estrogen receptors, progesterone receptors, and human epidermal growth factor receptor‐2, it is possible to obtain 8 tumor patterns categorized as triple‐negative, nonluminal (i.e. positive for human epidermal growth factor receptor‐2 with four subtypes) and luminal (negative for human epidermal growth factor receptor‐2 and positive for estrogen receptor and/or progesterone receptor with three subtypes) tumors. In general, luminal tumors are associated with a higher degree of tumor differentiation and have more favorable clinical outcomes. One of the subtypes of luminal tumors has an ER−/PR+ profile. This is a rather rare tumor subtype that behaves aggressively. The aim of this work was to analyse the proliferative activity of the eight tumor subgroups to verify if the ER−/PR+ type has a higher proliferative activity than the other subtypes, which might be correlated with its more aggressive behavior. To accomplish this, we examined estrogen receptor, progesterone receptor, human epidermal growth factor receptor‐2 and Ki67 data from 6643 cases of breast cancer. We found that the tumor type that was positive for only the progesterone receptor and negative for both the estrogen receptor and human epidermal growth factor receptor‐2 (1.3% of all cases) had a proliferative activity that was consistently much higher than those of the other luminal subtypes.

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It Is Not Time to Stop Progesterone Receptor Testing in Breast Cancer

Cited by 39 publications

References 4 publications

A systematic comparison of three commercial estrogen receptor assays in a single clinical outcome breast cancer cohort

A systematic comparison of three commercial estrogen receptor assays in a single clinical outcome breast cancer cohort

Biologic characteristics of premalignant breast disease

ER−/PR+/HER2− breast cancer type shows the highest proliferative activity among all other combined phenotypes and is more common in young patients: Experience with 6643 breast cancer cases

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