Oophorectomy and Tamoxifen Adjuvant Therapy in Premenopausal Vietnamese and Chinese Women With Operable Breast Cancer

Love, Richard R.; Duc, Nguyen Ba; Allred, D. Craig; Binh, Nguyen Cong; Định, Nguyễn Văn; Kha, Nguyen Ngoc; Thuan, Tran Van; Mohsin, Syed K.; Roanh, Le Dinh; Khang, Hoang Xuan; Tran, Trinh Luong; Quy, Tran Tu; Thuy, Nguyen Van; Thé, Pham Nhu; Cau, Ton That; Tung, Nguyen Dinh; Huong, Dang Thanh; Quang, Le Minh; Hiền, Nguyễn Ngọc; Thuong, Le Huynh Hoai; Shen, Tian-zhen; Ye, Xin; Zhang, Qian; Havighurst, Thomas C.; Yang, Yonghong; Hillner, Bruce E.; DeMets, David L.

doi:10.1200/jco.2002.08.169

Cited by 107 publications

(52 citation statements)

References 27 publications

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“…Panel of experts at College of American Pathologists, American Society of Clinical Oncology, and National Institute of Health in their last consensus statements had several reservations about assessing ER and PR by immunohistochemistry and noted a lack of standardized and validated assays. 3,4,9 Although a few validated immunohistochemistry methodologies have been published for ER, [10][11][12][13][14] none exist for PR. The few published studies that have assessed PR by immunohistochemistry consisted of patients of mixed clinical stages and variable treatment, making it impossible to separate the prognostic effects from the predictive value of PR.…”

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confidence: 99%

Progesterone receptor by immunohistochemistry and clinical outcome in breast cancer: a validation study

et al. 2004

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Progesterone receptor is a surrogate marker of estrogen receptor activity in breast cancer and its utility in helping predict clinical outcome has been established using biochemical assays. However, most laboratories worldwide have switched to immunohistochemistry to assess progesterone receptor, but unfortunately no validated immunohistochemical assay exists for progesterone receptor. The purpose of this study was to develop and validate an immunohistochemical assay for progesterone receptor in breast cancer. The assay was based on monoclonal antibody 1294 (DakoCytomation) and slides were scored microscopically using the 'Allred score' on a scale of 0-8. The assay was compared to ligand-binding assay in 1235 breast cancers, and a subset (n ¼ 362) that received only hormonal therapy was used to define a cutoff for progesterone receptorpositive. Clinical utility was validated in an independent set of samples (n ¼ 423) from a clinical trial randomizing premenopausal breast cancer patients to tamoxifen þ oophorectomy vs observation following surgery. A cutoff of 42 (corresponding to 41% positive cells) dichotomized patients with significantly better or worse clinical outcome (P ¼ 0.0014). Progesterone receptor by immunohistochemistry provided significantly better results than progesterone receptor by ligand-binding assay in predicting clinical outcome. In the clinical trial, a positive result in univariate analyses was associated with significantly improved disease-free and overall survival both in untreated (hazard ratios/P ¼ 0.656/0.060 and 0.479/0.005, respectively) and hormonally treated patients (hazard ratios/P ¼ 0.529/0.017 and 0.451/0.007, respectively). Positive progesterone receptor remained significant for improved disease-free and overall survival (hazard ratios/P ¼ 0.666/0.038 and 0.549/0.007, respectively) in multivariate analyses including the standard variables of tumor size, nodal status, treatment, histological grade, and HER-2/neu status. Estrogen and progesterone receptors are codependent variables and progesterone receptor was a weaker predictor of response to endocrine therapy than estrogen receptor when both were included in multivariate analysis. This is the first comprehensive study assessing the clinical usefulness of progesterone receptor by immunohistochemistry in archival tissue in breast cancer. Progesterone receptor assessed by immunohistochemistry provides useful information about clinical outcome and it is better than progesterone receptor measured by ligand-binding assay.

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confidence: 99%

Progesterone receptor by immunohistochemistry and clinical outcome in breast cancer: a validation study

et al. 2004

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“…All procedures were performed automatically by the BenchMark. IHC findings of ER and PgR were evaluated using Allred score, whose cut-off value has been clinically validated in several studies (20)(21)(22)(23)(24). To evaluate Her2 protein, a Herceptest was performed on each tumor (Dako, Glostrup, Denmark) and scored according to Herceptest criteria.…”

Section: Methodsmentioning

confidence: 99%

FOXP3 expression of micrometastasis-positive sentinel nodes in breast cancer patients

Matsuura

Yamaguchi²,

Osaki³

et al. 2009

Oncol Rep

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Abstract. A number of methods have been established for identifying sentinel nodes (SNs). In the present study, we attempted to clarify the immunological status of SNs with or without micrometastasis in breast cancer patients. SNs were identified by the dye-and Á probe-guided method. Total RNA was extracted from the SNs, and the expression of T-BET, GATA-3, and FOXP3 were evaluated using quantitative realtime reverse transcriptase-polymerase chain reaction (RT-PCR). Micrometastasis was identified as microscopically negative but positive by RT-PCR specific for mammaglobin. Of 88 patients, 17 (19.3%) showed positive metastasis in SNs (pN1, 14; pN2, 3). Of the 71 metastasis-negative SNs, 11 showed positive bands on RT-PCR specific for mammaglobin [pN0(mol+)]. There was no significant correlation among clinicopathological features with or without micrometastasis. Immunological parameters were compared among the 60 pN0, 11 pN0(mol+), and 17 pN1-2. Although T-BET expression was higher in pN0(mol+) than pN0, FOXP3 expression was also higher in pN0(mol+) than pN0. In pN1-2, T-BET expression decreased compared with pN0(mol+), but FOXP3 expression did not. On the other hand, GATA-3 expression inversely increased in pN1-2 compared with pN0(mol+). In patients with breast cancer, micrometastasis can stimulate Th1 response in SNs. However, the Treg cell response is also induced at the micrometastasis level and persists during the progression of metastasis in SNs. Then, the shift in the Th1/Th2 balance may preferentially lean toward Th2 responses in pN1-2 SNs and suppress antitumor immune responses. Micrometastasis [pN0(mol+)] is a status immunologically distinguishable from pN0 and pN1-2.

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“…54,56,57,60,72 Those available show that PgR is expressed in the nuclei of 60-70% of IBCs, that expression varies on a continuum ranging from 0 to nearly 100% positive cells, that there is a direct correlation between PgR levels and response to hormonal therapies, and that tumors with even very low levels of PgR-positive cells (Z1%) have a significant chance of responding. 54,72 Preliminary studies suggest that, similar to ERa, PgR expression is also associated with reduced local recurrence in patients with DCIS treated with lumpectomy and radiation followed by hormonal therapy. 66,67 Although the expression of PgR is highly correlated with ERa, the correlation is imperfect, resulting in four possible phenotypes of combined expression, each with significantly different rates of response to hormonal therapy, which would not be apparent measuring one or the other alone.…”

Section: Progesterone Receptormentioning

confidence: 99%

“…[5][6][7] Compared with ERa, there are fewer studies in the medical literature standardizing and validating IHC assays for PgR. 54,56,57,60,72 Those available show that PgR is expressed in the nuclei of 60-70% of IBCs, that expression varies on a continuum ranging from 0 to nearly 100% positive cells, that there is a direct correlation between PgR levels and response to hormonal therapies, and that tumors with even very low levels of PgR-positive cells (Z1%) have a significant chance of responding. 54,72 Preliminary studies suggest that, similar to ERa, PgR expression is also associated with reduced local recurrence in patients with DCIS treated with lumpectomy and radiation followed by hormonal therapy.…”

Section: Progesterone Receptormentioning

confidence: 99%

Issues and updates: evaluating estrogen receptor-α, progesterone receptor, and HER2 in breast cancer

2010

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There are currently three prognostic/predictive biomarkers used in routine clinical management of patients with breast cancer, and their assessment is mandatory. They include estrogen receptor-alpha (ERa), progesterone receptor (PgR), and the HER2 oncogene/oncoprotein. This paper briefly reviews the assessment of ERa, PgR, and HER2 in breast cancer, emphasizing recent progress and persistent controversies.

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Oophorectomy and Tamoxifen Adjuvant Therapy in Premenopausal Vietnamese and Chinese Women With Operable Breast Cancer

Abstract: Vietnamese and Chinese women with hormone receptor-positive operable breast cancer benefit from adjuvant treatment with surgical oophorectomy and tamoxifen.

Cited by 107 publications

References 27 publications

Progesterone receptor by immunohistochemistry and clinical outcome in breast cancer: a validation study

Progesterone receptor by immunohistochemistry and clinical outcome in breast cancer: a validation study

FOXP3 expression of micrometastasis-positive sentinel nodes in breast cancer patients

Issues and updates: evaluating estrogen receptor-α, progesterone receptor, and HER2 in breast cancer

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