J Breast Dis.  2017 Dec;5(2):64-70. 10.14449/jbd.2017.5.2.64.

Prognostic Value of Estrogen and Progesterone Receptor Expression in Low Proliferative Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer

• Lee Y
• Park I
• Cho H
• Yang K
• Kim J
• Park K
• Gwak G

• KMID: 2401817
• DOI: http://doi.org/10.14449/jbd.2017.5.2.64

Abstract

PURPOSE
Approximately two-thirds of breast cancer are estrogen-dependent cancers, which express estrogen receptor (ER)/progesterone receptor (PR). We investigated the prognostic value of ER/PR expression in human epidermal growth factor receptor 2 (HER2)-negative and low proliferative (Ki-67 ≤20%) breast cancer.
METHODS
A retrospective review was performed of 252 breast cancer data records, identified as ER/PR-positive, low Ki-67 proliferation index (≤20%) and HER2-negative. The data were divided into two subgroups: a strong luminal subgroup and a weak luminal subgroup, according to hormonal receptor expression status. Outcome measures included age at diagnosis, tumor size, tumor-node-metastasis (TNM) stage, ER, PR, Bcl-2, recurrent or metastatic characteristics, disease-free survival and overall survival, of each subgroup.
RESULTS
There were no statistical differences in TNM stage or tumor numbers between the two subgroups. The strong luminal subgroup was associated with a higher Bcl-2 expression (p<0.001). The weak luminal subgroup was associated with more frequent neural invasion (p=0.051) and lung (p=0.031), liver (p=0.031) and brain (p=0.033) metastases, than the strong luminal subgroup. Disease-free survival was significantly longer in the strong luminal subgroup than weak luminal subgroup (p=0.015). Overall survival was also significantly improved in the strong luminal subgroup relative to the weak luminal subgroup (p=0.014).
CONCLUSION
The weak luminal subgroup showed worse prognosis than the strong luminal subgroup, among ER/PR-positive HER2-negative low proliferative breast cancer patients. Weak ER or PR expression, can be considered a poor prognostic factor in ER/PR-positive HER2-negative low proliferative breast cancer.

Keyword

Breast neoplasms; Estrogen receptors; Progesterone receptors; Prognosis

MeSH Terms

Brain
Breast Neoplasms
Diagnosis
Disease-Free Survival
Epidermal Growth Factor*
Estrogens*
Humans*
Liver
Lung
Neoplasm Metastasis
Outcome Assessment (Health Care)
Phenobarbital
Progesterone*
Prognosis
Receptor, Epidermal Growth Factor*
Receptors, Estrogen
Receptors, Progesterone*
Retrospective Studies
Epidermal Growth Factor
Estrogens
Phenobarbital
Progesterone
Receptor, Epidermal Growth Factor
Receptors, Estrogen
Receptors, Progesterone