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Estrogen receptor-negative/progesterone receptor-positive and her-2-negative breast cancer might no longer be classified as hormone receptor-positive breast cancer

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Abstract

Background

The single progesterone receptor (PR)-positive phenotype (estrogen receptor (ER)-/PR + , sPR positive) is an infrequent and independent biological entity. However, the prognosis of patients with sPR-positive and her-2-negative phenotype is still controversial, and it is not always easy to decide treatment strategies for them.

Methods

Patients during 2010–2014 were identified from Surveillance, Epidemiology, and End Results (SEER) database. The Kaplan–Meier method was used to evaluate cancer-specific survival (CSS). The propensity score matching (PSM) method was used to balance differences of characteristics in groups. The Life-Table method was used to calculate 5-year CSS rates and the annual hazard rate of death (HRD).

Results

A total of 97,527 patients were included, and only 745 (0.76%) patients were sPR-positive phenotype. The majority of sPR-positive breast cancer were basal-like subtype. Survival analysis showed that the sPR-positive breast cancer had similar prognosis comparing to double hormonal receptor-negative (ER-/PR-, dHoR-negative) breast cancer, and had the highest HRD during the initial 1–2 years of follow-up, then maintained the HRD of almost zero during the late years of follow-up.

Conclusions

The patients with sPR-positive and her-2-negative breast cancer, similar to dHoR-negative breast cancer, had a worse survival, and could benefit from chemotherapy significantly. However, the escalating endocrine therapy was not recommended for sPR-positive patients. The patients with sPR positive should be excluded from future clinical trials concerning endocrine therapy.

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Funding

The study was supported by the Grant from the major program of the Jinhua Municipal Science & Technology Bureau (Grant number 2019-3-004) and the key program of the Jinhua Municipal Science & Technology Bureau (Grant number 2014-3-008).

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Author notes

  1. Hongjuan Zheng and Chenyang Ge are co-first authors; they contributed equally to the work.

Authors and Affiliations

  1. Department of Medical Oncology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, 351 Mingyue Road, Jinhua, 321000, Zhejiang Province, China

    Hongjuan Zheng, Qinghua Wang, Shishi Zhou, Wanfen Tang, Xia Zhang, Xiayun Jin, Xifeng Xu & Jianfei Fu

  2. Department of Colorectal Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, 351 Mingyue Road, Jinhua, 321000, Zhejiang Province, China

    Chenyang Ge & Jinlin Du

  3. Department of Hepatobiliary Surgery, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China

    Haiping Lin

  4. Department of Gastroenterology, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China

    Lunpo Wu

  5. Institute of Gastroenterology, Zhejiang University, Hangzhou, China

    Lunpo Wu

  6. Department of Oncology, Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, 321000, Zhejiang Province, China

    Zhongwu Hong

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  1. Hongjuan Zheng
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Zheng, H., Ge, C., Lin, H. et al. Estrogen receptor-negative/progesterone receptor-positive and her-2-negative breast cancer might no longer be classified as hormone receptor-positive breast cancer. Int J Clin Oncol 27, 1145–1153 (2022). https://doi.org/10.1007/s10147-022-02158-0

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