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Clinical relevance of the reappraisal of negative hormone receptor expression in breast cancer.

Pinto AE, Areia F, Pereira T, Cardoso P, Aparício M, Silva GL, Ferreira MC, André S - Springerplus (2013)

Bottom Line: Accurate assessment of estrogen (ER) and progesterone (PR) receptors is critical in predicting the response to endocrine therapies in breast cancer.From 101 ER- and 158 PR- cases, 38 (37.6%) and 58 (36.7%) became positive, increasing ER and PR expression from 71.9% and 56.1% to 82.5% and 72.2%, respectively (P<0.001).Kaplan-Meier survival curves showed significant differences related to RFS and OS for PR, either in the whole series or in the subset (n = 151) submitted to hormonal treatment.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Matemática do Instituto Superior Técnico da Universidade Técnica de Lisboa, Lisboa, Portugal.

ABSTRACT

Background: Accurate assessment of estrogen (ER) and progesterone (PR) receptors is critical in predicting the response to endocrine therapies in breast cancer.

Material and methods: From a series of 360 patients with breast invasive carcinoma assessed for hormone receptors by immunohistochemistry (IHC) in the 90's, we re-analysed, on the same tumour material, the cases considered negative (n = 164), i.e., ER-/PR- (n = 95), ER+/PR- (n = 63) and ER-/PR+ (n=6), and 16 of 196 ER+/PR+ tumours with unfavourable outcome. Concordance between the previous IHC (Streptavidin-Biotin-Peroxidase) method and the current one (Peroxidase-Indirect-Polymer) was determined by the McNemar's test. Relapse-free (RFS) and overall survival (OS) were estimated by the Kaplan-Meier method.

Results: From 101 ER- and 158 PR- cases, 38 (37.6%) and 58 (36.7%) became positive, increasing ER and PR expression from 71.9% and 56.1% to 82.5% and 72.2%, respectively (P<0.001). All 16 ER+/PR+ cases maintained their co-positivity, while all ER-/PR+ tumours changed to ER positive. Kaplan-Meier survival curves showed significant differences related to RFS and OS for PR, either in the whole series or in the subset (n = 151) submitted to hormonal treatment. The patients' subgroup with ER+/PR- tumours exhibited the worst prognosis.

Conclusion: The current IHC method improves the clinical usefulness of ER/PR assessment by decreasing the rate of false negative results.

No MeSH data available.


Related in: MedlinePlus

Probability of patients' survival in the whole series (n=360) according to PR expression using the current method with >10% cut-off A) RFS (P=0.010) and B) OS (P<0.001).
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Fig2: Probability of patients' survival in the whole series (n=360) according to PR expression using the current method with >10% cut-off A) RFS (P=0.010) and B) OS (P<0.001).

Mentions: The Kaplan-Meier survival estimates analyses showed significant differences between overall survival curves for PR expression, using the IHC method of the 90’s (P = 0.017) and the current IHC method (with a >10% cut-off) (P<0.001), the latter also showing significance in relation to disease recurrence (P = 0.010) (Figure 2). Using this method (with a >10% cut-off), we found that the subgroup of patients with ER+/PR- tumours presented the worst prognosis for RFS (P = 0.013) and OS (P=0.002) (Figure 3). Comparing the K-M curves for OS, the adverse clinical outcome in this subset of patients is more pronounced after five years of follow-up.Figure 2


Clinical relevance of the reappraisal of negative hormone receptor expression in breast cancer.

Pinto AE, Areia F, Pereira T, Cardoso P, Aparício M, Silva GL, Ferreira MC, André S - Springerplus (2013)

Probability of patients' survival in the whole series (n=360) according to PR expression using the current method with >10% cut-off A) RFS (P=0.010) and B) OS (P<0.001).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3755814&req=5

Fig2: Probability of patients' survival in the whole series (n=360) according to PR expression using the current method with >10% cut-off A) RFS (P=0.010) and B) OS (P<0.001).
Mentions: The Kaplan-Meier survival estimates analyses showed significant differences between overall survival curves for PR expression, using the IHC method of the 90’s (P = 0.017) and the current IHC method (with a >10% cut-off) (P<0.001), the latter also showing significance in relation to disease recurrence (P = 0.010) (Figure 2). Using this method (with a >10% cut-off), we found that the subgroup of patients with ER+/PR- tumours presented the worst prognosis for RFS (P = 0.013) and OS (P=0.002) (Figure 3). Comparing the K-M curves for OS, the adverse clinical outcome in this subset of patients is more pronounced after five years of follow-up.Figure 2

Bottom Line: Accurate assessment of estrogen (ER) and progesterone (PR) receptors is critical in predicting the response to endocrine therapies in breast cancer.From 101 ER- and 158 PR- cases, 38 (37.6%) and 58 (36.7%) became positive, increasing ER and PR expression from 71.9% and 56.1% to 82.5% and 72.2%, respectively (P<0.001).Kaplan-Meier survival curves showed significant differences related to RFS and OS for PR, either in the whole series or in the subset (n = 151) submitted to hormonal treatment.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Matemática do Instituto Superior Técnico da Universidade Técnica de Lisboa, Lisboa, Portugal.

ABSTRACT

Background: Accurate assessment of estrogen (ER) and progesterone (PR) receptors is critical in predicting the response to endocrine therapies in breast cancer.

Material and methods: From a series of 360 patients with breast invasive carcinoma assessed for hormone receptors by immunohistochemistry (IHC) in the 90's, we re-analysed, on the same tumour material, the cases considered negative (n = 164), i.e., ER-/PR- (n = 95), ER+/PR- (n = 63) and ER-/PR+ (n=6), and 16 of 196 ER+/PR+ tumours with unfavourable outcome. Concordance between the previous IHC (Streptavidin-Biotin-Peroxidase) method and the current one (Peroxidase-Indirect-Polymer) was determined by the McNemar's test. Relapse-free (RFS) and overall survival (OS) were estimated by the Kaplan-Meier method.

Results: From 101 ER- and 158 PR- cases, 38 (37.6%) and 58 (36.7%) became positive, increasing ER and PR expression from 71.9% and 56.1% to 82.5% and 72.2%, respectively (P<0.001). All 16 ER+/PR+ cases maintained their co-positivity, while all ER-/PR+ tumours changed to ER positive. Kaplan-Meier survival curves showed significant differences related to RFS and OS for PR, either in the whole series or in the subset (n = 151) submitted to hormonal treatment. The patients' subgroup with ER+/PR- tumours exhibited the worst prognosis.

Conclusion: The current IHC method improves the clinical usefulness of ER/PR assessment by decreasing the rate of false negative results.

No MeSH data available.


Related in: MedlinePlus