Progesterone receptor activity and relapse-free survival in patients with primary breast cancer: The role of adjuvant chemotherapy
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The prognostic significance of progesterone receptor activity (PgR) with regard to the estimated relapse-free survival (RFS) was studied in 350 one-center patients with primary breast cancer. All receptor assays were performed in one laboratory; PgR levels >10 fmol/mg protein were considered positive. Univariate as well as multivariate statistical analyses were used to examine the prognostic significance of several variables. Eighty-nine of the 350 patients received adjuvant CMF chemotherapy (cyclophosphamide, methotrexate, and 5-fluorouracil). The median observation period was 69 months (range 12–125 months).
In the group of 261 patients who did not receive adjuvant CMF, the PgR-status lacked prognostic significance; only the lymph node status significantly affected the RFS (p<0.00001). In contrast, in the CMF-treated group of patients, the PgR-status was the most powerful predictor of recurrence (p<0.0001). The menopausal and the lymph-node status increased the predictive value of PgR (p<0.001). Premenopausal CMF-treated patients with PgR+ tumors had a significantly longer RFS than those with PgR− tumors (p<0.02). The present data urge the need for a reappraisal of the prognostic significance of PgR and of the mechanism of action of adjuvant chemotherapy in primary breast cancer.
Key wordsadjuvant chemotherapy breast cancer progesterone receptor prognosis
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- 3.Howell A, Harland RNL, Bramwell VHC, Swindell R, Barnes DM, Redford J, Wilkinson MJS, Crowther D, Sellwood RA: Steroid-hormone receptors and survival after first relapse in breast cancer. Lancet i: 558–591, 1984Google Scholar
- 5.Raemaekers JMM, Beex LVAM, Koenders AJM, Pieters GFFM, Smals AGH, Benraad ThJ, Kloppenborg PWC, and the Breast Cancer Group: Disease-free interval and estrogen receptor activity in tumor tissue of patients with primary breast cancer: analysis after long-term follow-up. Breast Cancer Res Treat 6: 123–131, 1985PubMedGoogle Scholar
- 9.Cox DR: Regression models and life-tables. J R Stat Soc 34: 187–200, 1972Google Scholar
- 10.Dixon WJ (ed): BMDP statistical software. Berkeley California Press, 1983Google Scholar
- 17.Coradini D, Scavone GF, Cappelletti V, Miodini P, Granata G, Di Fronzo G: Assessment of the prognostic relevance of PgR in addition to ER in node negative breast cancer patients. Abstract: International Congress on Endocrinology and Malignancy, Rome, 22–27 April 1986. Anticancer Res 6: 373, 1986Google Scholar
- 23.Kaufmann M, Klinga K: Mögliche prognostische Kriterien zur Therapie-Verbesserung beim primären Mammakarzinom. Geburtsh u Frauenheilk 42: 501–509, 1982Google Scholar
- 26.Fisher B, Redmond CK, Wickerham DL, Rockette HE, and Brown A, with the contribution of Allegra J, Bowman D, Plotkin D, Wolter J and other NSABP investigators: Relation of estrogen and/or progesterone receptor content of breast cancer to patient outcome following adjuvant therapy. Breast Cancer Res Treat 3: 355–365, 1983PubMedGoogle Scholar
- 27.Howell A, George WD, Crowther D, Rubens RD, Bulbrook RD, Bush H, Howat JMT, Sellwood RA, Hayward JL, Fentiman IS, Chaudary M: Controlled trial of adjuvant chemotherapy with cyclophosphamide, methotrexate and fluorouracil for breast cancer. Lancet ii: 307–311, 1983Google Scholar
- 30.Padmanabhan N, Howell A, Rubens RD: Mechanism of action of adjuvant chemotherapy in early breast cancer. Lancet ii: 411–415, 1986Google Scholar