Relative effect of steroid hormone receptors on the prognosis of patients with operable breast cancer. A univariate and multivariate analysis of 3089 Japanese patients with breast cancer from the study group for the Japanese breast cancer society on hormone receptors and prognosis in breast cancer

Abstract

In a retrospective multicenter study to investigate the correlation between estrogen (ER) and/or progesterone receptors (PgR) in primary breast cancer with patient Prognosis, 3118 patients with operable breast cancer (International Union Against Cancer Stages I, II, and III) were investigated from ten hospitals in Japan who underwent surgery from October 1972 to December 1982; 3089 were evaluable. The ER‐positive and PgR‐positive cancers were found in 56% and 34% of patients, respectively. The positivities decreased as the tumor size increased but were independent on lymph node metastasis. There were no significant differences in relapse‐free survival (RFS) in relation to receptor status (median follow‐up, 89 months [ER], 84 months [PgR]). However, in patients with four or more positive nodes, those with PgR‐positive cancer had a longer RFS. The patients with ER‐positive cancer survived significantly longer than ER‐ negative ones, with the greatest difference seen in those with four or more positive nodes. There was a significantly longer postrelapse survival (PRS) for patients with ER‐positive cancer because of the different distribution of the major metastasis and better responses to first line and subsequent treatment. Cox's multivariate analysis showed that overall survival but not PRS was affected by ER (and more weakly by PgR) because of the longer PRS in patients with ER‐positive cancer.

Serum CEA and CA 15-3 as prognostic factors in primary breast cancer

“…In accordance to other studies, we found tumour size, lymph nodes, histological grading and hormone receptors to be prognostically significant for DFS and DFD (Chevallier et al, 1988;Carter et al, 1989;Nomura et al, 1992;Carriaga and Henson, 1995).…”

“…Nonetheless it remains a challenge to predict which patients are at greatest risk of relapse and thus may benefit most from adjuvant therapy (McGuire and Clark, 1992;Mansour et al, 1994). In addition to traditional prognostic factors in breast cancer such as tumour size, axillary lymph node status, histological grading and hormone receptor status (Clark et al, 1987;Chevallier et al, 1988;Carter et al, 1989;Nomura et al, 1992;Carriaga and Henson, 1995), newer parameters like Her-2/neu, cathepsin D or urokinase plasminogen activator (uPA) and plasminogen activator inhibitor 1 (PAI-1) are under consideration (Mansour et al, 1994;Schmitt et al, 1997). Circulating tumour markers as Carcinoembryonic Antigen (CEA) and Cancer Antigen 15-3 (CA 15-3) have become well established diagnostic tools as fast, non-invasive, reproducible and quantitative parameters in follow-up care and monitoring therapy of breast cancer patients.…”

Effect of Obesity on Breast Cancer Development

“…39,103 In vitro studies using human breast cancer cell lines have provided evidence that estrogen is mitogenic in mammary cancer cells. 24,32,37,108 In addition, estrogen receptor (ER) status is closely related to prognosis; that is, ER-negative tumors tend to have a worse prognosis than do ER-positive tumors, 85,116 in part because ER-negative tumors do not respond to important anticancer therapies such as tamoxifen. Additional factors that are implicated as important links between obesity and mammary tumorigenesis include insulin and insulinlike growth factor 1 56,73,79 for which elevated levels have been associated with premenopausal breast cancer.…”

Hormone receptors and proliferation in breast carcinomas of equivalent histologic grades in pre‐ and postmenopausal women

“…There is a general consensus that ER content is a weak prognosticator, with most studies conferring a more favorable prognosis to ER-positive tumors. [82][83][84] Our results support this contention, but only in postmenopausal women. In contrast, other investigators have reported that, in postmenopausal women, a high ER content may confer a more aggressive tumor behavior prior to receiving adjuvant therapy.…”