J Breast Cancer.  2009 Sep;12(3):156-162. 10.4048/jbc.2009.12.3.156.

The Clinical Significance of the Estrogen Receptor beta Expression for Endocrine Therapy in Patients with ERalpha-negative and Progesterone Receptor-positive Breast Carcinoma

• Park MH
• Ryu HS
• Ro HW
• Cho JS
• Yoon JH
• Jegal YJ
• Kim JH
• Lee JS
• Park CS

• KMID: 2242006
• DOI: http://doi.org/10.4048/jbc.2009.12.3.156

Abstract

PURPOSE
Estrogen receptor (ER) is the key therapeutic target in breast cancer. ERbeta has recently been identified to be distinct from ERalpha. In contrast to ERalpha, the functions of ERbeta in breast cancer are still unclear. We sought to determine whether the expression of ERbeta can be used as a predictive marker for endocrine therapy for patients with ERalpha-negative breast cancer.
METHODS
Formalin-fixed, paraffin-embedded tumor specimens from 52 patients with ER-/PR+ invasive breast cancer were immunostained for their ERbeta expression. These patients were treated with adjuvant tamoxifen. The results were correlated with various clinicopathological variables and the follow-up data. The expressions of p53 and HER-2/neu were also analyzed and correlated with the ERbeta status.
RESULTS
An ERbeta expression was observed in 53.8% (28/52) of the breast cancer samples. There was no correlation between the ERbeta expression and the other clinicopathologic factors (age, tumor size, histologic type, nodal status, histological grade, stage, therapeutic modality, progesterone receptor (PR) expression, p53 expression and HER-2/neu expression). Recurrence was present in 7.7% (2/26) of the patients whose tumors had an ERbeta expression, as compared to the presence of recurrence in 36.4% (8/22) of the patients whose tumors had no ERbeta expression (p<0.05). The patients with ERbeta negative-tumors revealed lower disease free survival rate than those with ERbeta positive-tumors (p<0.05). Of the 52 patients, 10 (19.2%) were p53 positive, and 11 (21.2%) were HER-2/neu positive. No significant correlations were observed between ERbeta and p53 or HER-2/neu.
CONCLUSION
These results suggest that ERbeta might be a predictive marker of a response to endocrine therapy in patients with ER-/PR+ invasive breast cancer, although this needs to be confirmed by additional studies.

Keyword

Breast neoplasms; Endocrine therapy; Estrogen receptor beta

MeSH Terms

Breast
Breast Neoplasms
Disease-Free Survival
Estrogen Receptor alpha
Estrogen Receptor beta
Estrogens
Follow-Up Studies
Humans
Progesterone
Receptors, Progesterone
Recurrence
Tamoxifen
Estrogen Receptor alpha
Estrogen Receptor beta
Estrogens
Progesterone
Receptors, Progesterone
Tamoxifen

Figure

• 

  Figure 1 Immunoreactivity for ERβ. (A) In normal breast lobules, the protein expressed in the majority of luminal epithelial cells (×400). (B) Intense immunoreactivity for ERβ is noted in the nuclei of an invasive ductal carcinoma (×200). ERβ=estrogen receptor beta.

• 

  Figure 2 Kaplan-Meier curves for ERβ expression in breast carcinoma patients. Patients with ERβ negative-tumors suffered a significantly decreased disease free survival (log-rank test, p<0.05). ERβ=estrogen receptor beta.

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  Figure 3 Invasive ductal carcinoma with intense nuclear staining for p53 (×200).

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  Figure 4 Invasive ductal carcinoma with intense membrane staining for HER-2/neu (×200).

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