Progesterone receptor status of breast cancer metastases

Abstract

It seems that the lack of positive progesterone receptors in metastasis (0/8) and conversion from PR+ primary to PR- metastasis (5/8) may be important in describing the non-responder phenotype. We obtained a similar progression-free interval in patients with progesterone receptor-positive/negative primary tumors, but a longer progression-free interval in the patients with progesterone receptor-positive metastases ( n=9) than with negative ones ( n=14), indicating the possibility of using steroid receptor content from metastases for metastatic disease therapy planning.

Receptor conversion in distant breast cancer metastases

“…Previous studies (all using the 10% threshold when indicated) reported PR conversion rates from 28% to 61%, again higher than in the present study. The explanation for this may be similar to what has been mentioned above: previous studies did not restain both the primary and metastatic lesions [5,8,10,11], used ligand-binding assays [2,7,10], or included bone metastases [2,6,8-10,12]. Further, our series is much larger with 233 compared to most previous PR studies with 9 to 59 cases.…”

“…The explanation for this finding may be that previous ERα studies did not restain both the primary and metastatic lesions [3,5,8,10,11], used ligand-binding assays [2,3,7,10] (where the result is influenced by differences in the percentage of non-tumor cells in the samples), or included bone metastases that may suffer from false negative IHC results due to decalcification [2,4,6,8-10,12]. In addition, with 233 cases our series is much larger than most previous ERα studies.…”

“…Unfortunately, the previous conversion studies suffer from several limitations: small size (six studies contain <30 cases and eight studies ≤62 cases) [2,3,6,7,9,10,12-15,18-20,22], only one metastatic site studied [9,18], using a ligand-binding assay [2,3,7,10], which, especially in the case of metastases, may be biased by low cellularity and contamination by nonmalignant cells, inclusion of decalcified bone metastases [2,4,6,8-10,12,16,19,20,22] that may give rise to false negative immunohistochemistry, extraction of original immunohistochemistry results from the pathology report instead of repeating the staining [3,5,8,10,11,23], and/or use of tissue arrays [21] which may introduce sampling bias. Therefore, the available data may not be sufficiently reliable to change current clinical practice, although several guidelines already advise to rebiopsy distant metastases when possible [27,28].…”

Solitary Hypothalamus Triple Negative Metastasis from Luminal: A Primary Breast Carcinoma

“…In biopsies from patients who developed resistance to tamoxifen, changes in hormone receptor status, as well as in other signalling pathway molecules, such as HER2, have also recently been documented [18]. Similarly, to ER, and perhaps even at a higher rate, a significant proportion of PR-positive tumours also lose PR expression in their metastasis [19], and loss of PR in sequential biopsies, particularly with intervening endocrine therapy, is associated with poorer survival as compared with patients retaining PR [20]. Nevertheless, trials in metastatic disease suggest that these tumours still benefit from endocrine therapy [21], although some data suggest that they may have a somewhat worse clinical outcome than ER-positive tumors [22].…”

Mechanisms of development and the ways to overcome endocrine resistance in breast cancer

“…HER2 может являться ведущим фактором в прогрессии опухоли, являясь альтернативным путем выживания, либо уменьшая уровень РЭ, делая опухоль менее чувствитель-ной к эстрогену [43,72]. С другой стороны, РП теряются опухолью после начала эндокринной терапии гораздо чаще, нежели РЭ, в связи с чем опухоль становится более агрессивной, а у пациен-тов с такими опухолями выживаемость хуже, чем у паци-ентов, больных опухолями, сохранивших РП [73,75]. Получение ответа на лечение одним из видов эндокринной терапии после прогрессии заболевания на фоне лечения другим видом -исторически известный факт, являющий-ся ключевым в лечении метастатической болезни при РМЖ [7].…”