Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Mar 18:15:138.
doi: 10.1186/s12885-015-1121-4.

Poor prognosis of single hormone receptor- positive breast cancer: similar outcome as triple-negative breast cancer

Soo Youn Bae  1 , Sangmin Kim  2 , Jun Ho Lee  3 , Hyun-Chul Lee  4 , Se Kyung Lee  5 , Won Ho Kil  6 , Seok Won Kim  7 , Jeong Eon Lee  8 , Seok Jin Nam  9
Affiliations

Poor prognosis of single hormone receptor- positive breast cancer: similar outcome as triple-negative breast cancer

Soo Youn Bae et al. BMC Cancer. .

Abstract

Background: Response to endocrine therapy in breast cancer correlates with estrogen receptor (ER) and progesterone receptor (PR) status. Generally, hormone receptor-positive (HR+) breast cancers have favorable prognosis. In order to understand the exact clinical characteristics and prognosis of single HR-positive breast cancer (ER + PR- tumors and ER-PR+ tumors), we compared these tumors to double HR+ tumors as well as HR- negative tumors (ER-PR-).

Methods: We examined the clinical and biological features of 6,980 women with invasive ductal carcinoma, and these patients were stratified according to ER and PR expression as double HR+ (ER + PR+), single HR+ (ER + PR- and ER-PR+) and double HR-negative (HR-, ER-PR-) tumors.

Results: In this study, 571 (8.2%) cases were single HR+ tumors, of which 90 (1.3%) were ER-PR+ tumors and 481 (6.9%) were ER + PR- tumors. Our multivariate analysis showed that in patients without HER2 overexpression ER + PR- tumors were associated with an increased risk of recurrence and death compared with ER + PR+ tumors, with a hazard ratio of 2.12 for disease-free survival (DFS) and 4.79 for overall survival (OS). In patients without HER2 overexpression ER-PR+ tumors had increased risk of recurrence and death compared with ER + PR+ tumor, with a hazard ratio of 4.19 for DFS and 7.22 for OS. In contrast, in patients with HER2 overexpression, the difference in survival between single HR+ tumors and double HR+ HR- tumors was not statistically significant. In patients without HER2 overexpression the DFS and OS of ER + PR- and ER-PR+ tumors were not significantly different from those of ER-PR- tumors.

Conclusion: We have identified clinically and biologically distinct features of single HR+ tumors (ER-PR+ and ER + PR-) through comparison with both ER + PR+ and ER-PR- tumors. These differences were only significant in HER2- tumors, not in HER2+ tumors. Single HR+ tumors without HER2 overexpression (ER + PR-HER2- or ER-PR + HER2-) were associated with poorer survival than ER + PR + HER2- tumors, and had comparable poor survival to ER-PR-HER2- tumors (triple-negative breast cancer).

PubMed Disclaimer

Figures

Figure 1
Figure 1
(a) Disease-free survival (DFS) and (b) overall survival (OS) of all patients.
Figure 2
Figure 2
(a) Disease-free survival (DFS) and (b) overall survival (OS) of patients with HER2-positive tumors.
Figure 3
Figure 3
(a) Disease-free survival (DFS) and (b) overall survival (OS) of patients with HER2-negative tumors.
See this image and copyright information in PMC

References

    1. Bardou V-J, Arpino G, Elledge RM, Osborne CK, Clark GM. Progesterone Receptor Status Significantly Improves Outcome Prediction Over Estrogen Receptor Status Alone for Adjuvant Endocrine Therapy in Two Large Breast Cancer Databases. J Clin Oncol. 2003;21(10):1973–1979. doi: 10.1200/JCO.2003.09.099. - DOI - PubMed
    1. Elledge RM, Green S, Pugh R, Allred DC, Clark GM, Hill J, et al. Estrogen receptor (ER) and progesterone receptor (PgR), by ligand-binding assay compared with ER, PgR and pS2, by immuno-histochemistry in predicting response to tamoxifen in metastatic breast cancer: a Southwest Oncology Group Study. Int J Cancer. 2000;89(2):111–7. doi: 10.1002/(SICI)1097-0215(20000320)89:2<111::AID-IJC2>3.0.CO;2-W. - DOI - PubMed
    1. Ravdin PM, Green S, Dorr TM, McGuire WL, Fabian C, Pugh RP, et al. Prognostic significance of progesterone receptor levels in estrogen receptor-positive patients with metastatic breast cancer treated with tamoxifen: results of a prospective Southwest Oncology Group study. J Clin Oncol. 1992;10(8):1284–91. - PubMed
    1. Arpino G, Weiss H, Lee AV, Schiff R, De Placido S, Osborne CK, et al. Estrogen Receptor–Positive, Progesterone Receptor–Negative Breast Cancer: Association With Growth Factor Receptor Expression and Tamoxifen Resistance. J Natl Cancer Inst. 2005;97(17):1254–1261. doi: 10.1093/jnci/dji249. - DOI - PubMed
    1. Punglia RS, Kuntz KM, Winer EP, Weeks JC, Burstein HJ. The impact of tumor progesterone receptor status on optimal adjuvant endocrine therapy for postmenopausal patients with early-stage breast cancer. Cancer. 2006;106(12):2576–2582. doi: 10.1002/cncr.21919. - DOI - PubMed

Publication types

MeSH terms