Breast Cancer Research and Treatment

, Volume 49, Issue 3, pp 219–225 | Cite as

Estrogen receptor negative and progesterone receptor positive primary breast cancer: Pathological characteristics and clinical outcome

  • Agnès Bernoux
  • Patricia de Cremoux
  • Christine Lainé-Bidron
  • Emmanuel C. Martin
  • Bernard Asselain
  • Henri Magdelénat


The expression of estrogen (ER) and progesterone (PgR) receptors was analyzed in a retrospective series of 3000 patients who had operable primary breast cancer. Patients were stratified according to ER and PgR status and the study was focused on the two groups (ER−PgR+ and ER−PgR−) of patients whose tumors contained low levels of ER (< 15 fmol/mg protein), regarding potential response to endocrine therapy. The comparison of clinical or histological characteristics between ER−PgR+ and ER−PgR− patients was analyzed as well as the disease-related death and survival. The mean follow-up was 86.3 months. Among the 529 ER−patients, 62 were PgR+ (12%), whereas 467 were PgR− (88%). The ER−PgR+ and ER−PgR− populations represented 2% and 15.6% of the overall population, respectively. In ER− tumors, the PgR status was significantly related to: age, menopausal status, tumor size, SBR grade, and histological type, but not to the type of surgical treatment or to lymph node involvement. ER−PgR+ tumors had smaller size (64% T1 vs 43%) (p=0.004) and were more frequently grade I (28% vs 12%) than ER−PgR− ones (p < 0.001). In addition, the patients with ER−PgR+ tumors were significantly younger (49.4 years vs 58.4 years; p < 0.0001), and were more frequently premenopausal (76% vs 36%; p < 0.001). The disease-free interval and the metastasis-free survival tended to be worse for ER−PgR− than for ER−PgR+ patients, but the difference was not statistically significant at 10 years. However, a small but significant difference in overall survival, in favor of the PgR+ group, was observed between the two groups during the first 5 years (p=0.03).

We conclude that in combination with ER, PgR status defines a group of patients with clinical and biological specificity, which could be considered for specific endocrine therapy.

breast cancer hormone receptors prognosis 


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  1. 1.
    McGuire WL: Hormone receptors, their role in predicting prognosis and response to endocrine therapy. Sem Oncol 5: 428–433, 1978Google Scholar
  2. 2.
    Foekens JA, Look MP, Peters HA, Van Putten WLJ, Portengen H, Klijn JGM: Urokinase-type plasminogen activator and its inhibitor PAI 1; predictors of poor response to tamoxifen therapy in recurrent breast cancer. J Natl Cancer Inst 87: 751–757, 1995Google Scholar
  3. 3.
    Thorpe SM, Rose C, Rassmussen BB, Mouridsen HT, Bayer T, Keiding N (on behalf of the Danish Breast Cancer Cooperative Group): Prognostic value of steroid hormone receptors: multivariate analysis of systemically untreated patients with node negative primary breast cancer. Cancer Res 47: 6126–6133, 1987Google Scholar
  4. 4.
    Ravdin P, Green S, Dorr TM, McGuire WL, Fabian C, Pugh RP, Carter RD, Rivkin SE, Borst JR, Belt BJ, Metch B, Osborne CK: 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 10: 1284–1291, 1992Google Scholar
  5. 5.
    Clark GM, McGuire WL, Hubay CA, Pearson OH, Marshall JS: Progesterone receptors as a prognostic factor in stage II breast cancer. N Engl J Med 309: 1343–1347, 1983Google Scholar
  6. 6.
    Leclercq G, Heuson JC, Deboel MC: Estrogen and progesterone receptors in human breast cancer. In: McGuire WL, Raynaud JP, Baulieu EE (eds) Progesterone Receptors in Normal and Neoplastic Tissues. Raven Press, New York, 1977, pp 141–153Google Scholar
  7. 7.
    McGuire WL, Horwitz KB, Pearson OH, Segaloff A: Current status of estrogen and progesterone receptors in breast cancer. Cancer 39: 2934–2947, 1977Google Scholar
  8. 8.
    Sarrif AM, Durant JR: Evidence that estrogen-receptor-negative, progesterone-receptor-positive breast and ovarian carcinoma contain estrogen receptor. Cancer 48: 1215–1221, 1981Google Scholar
  9. 9.
    Kiang DT, Kollander R: Dreast cancers negative for estrogen receptor but positive for progesterone receptor, a true entity? J Clin Oncol 5: 662–666, 1987Google Scholar
  10. 10.
    Pichon MF, Milgrom E: Oestrogen receptor-negative-progesterone receptor positive phenotype in 1,211 breast tumours. Br J Cancer 6: 895–897, 1992Google Scholar
  11. 11.
    Pichon MF, Broet P, Magdelénat H, Delarue JC, Spyratos F, Basuyau JP, Saez S, Rallet A, Courrière P, Millon R, Asselain B: Prognostic value of steroid receptors after long-term follow up of 2257 operable breast cancers. Br J Cancer 73: 1545–1551, 1996Google Scholar
  12. 12.
    Bloom HJ, Richardson WW: Histological grading and prognosis in breast cancer. A study of 1409 cases of which 359 have been followed 15 years. Br J Cancer 11: 359–377, 1957Google Scholar
  13. 13.
    Magdelénat H, Gerbault-Sereureau M, Lainé-Bidron C, Prieur M, Dutrillaux B: Genetic evolution of breast cancer: II. Relationship with estrogen and progesterone receptor expression. Breast Cancer Res Treat 22: 119–127, 1992Google Scholar
  14. 14.
    Goussard J, Magdelénat H, Martin PM: Monoclonal antibodies for progesterone receptor assays and polymorphism studies in breast cancer. Comparison with radioligand assays. Bull Cancer 75: 771–782, 1988Google Scholar
  15. 15.
    Blankenstein MA: Comparison of a ligand binding assay and enzyme immunoassay of estrogen receptor in human breast cancer cytosols. Breast Cancer Res Treat 17: 91–98, 1990Google Scholar
  16. 16.
    Leclercq G, Bojar H, Goussard J, Nicholson RI, Pichon MF, Piffanelli A, Pousette A, Thorpe S, Lonsdorfer M: Abbott monoclonal enzyme immunoassay measurement of estrogen receptors in human breast cancer: a European Multicenter study. Cancer Res 46: 4233s-4236s, 1986Google Scholar
  17. 17.
    Magdelénat H, Merle S, Zajdela A: Enzyme immunoassay of estrogen receptors in fine needle aspirates of breast tumors. Cancer Res 46: 4265s-4267s, 1986Google Scholar
  18. 18.
    Fiszer-Szafars B, Szafars D, Guevazade de Murillo A: A general, fast and sensitive micromethod for DNA determination. Anal Biochem 110: 165–170, 1981Google Scholar
  19. 19.
    Kaplan EL, Meier P: Non parametric estimation for incomplete observation. J Am Stat Assoc 53: 457–471, 1958Google Scholar
  20. 20.
    Mantel N: Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep 50: 163–170, 1966Google Scholar
  21. 21.
    Cox DR: Regression models and life table. J R Stat Soc B 34: 187–202, 1972Google Scholar
  22. 22.
    Thorsen T: Occupied and non occupied estradiol receptors in human breast tumor cytosol. J Steriod Biochem 13: 405–408, 1980Google Scholar
  23. 23.
    Fuqua SAW, Fitzgerald SD, Chamness GC, Tandon AK, McDonnell DP, Nawaz S, O'Malley BW, McGuire WL: Variant human breast tumour estrogen receptor with constitutive transcriptional activity. Cancer Res 51: 105–109, 1991Google Scholar
  24. 24.
    Raemaekers JMM, Beex LVAM, Pieters GFFM, Smals AGH, Benraad TJ, Kloppenborg PWC, and the Breast Cancer Study Group: Progesterone receptor activity and relapse-free survival in patients with primary breast cancer: the role of adjuvant chemotherapy. Breast Cancer Res Treat 9: 191–199, 1987Google Scholar
  25. 25.
    Olivares R, Magdelénai H, Pouillart P, Asselain B: Does chemotherapy interact with hormonal receptor status in breast cancer? (Abstract), Hormones and Breast Cancer, from Biology to the Clinic, Nice, 1992Google Scholar
  26. 26.
    Hahnel R, Woodings T, Vivian AB: Prognostic value of estrogen receptors in primary breast cancer? Cancer 44: 671–675, 1979Google Scholar
  27. 27.
    Keshgegian AA, Cnaan A: Estrogen receptor-negative, progesterone receptor-positive breast carcinoma: poor clinical outcome. Arch Pathol Lab Med 120: 970–973, 1996Google Scholar

Copyright information

© Kluwer Academic Publishers 1998

Authors and Affiliations

  • Agnès Bernoux
    • 1
  • Patricia de Cremoux
    • 2
    • 3
  • Christine Lainé-Bidron
    • 2
  • Emmanuel C. Martin
    • 2
  • Bernard Asselain
    • 1
  • Henri Magdelénat
    • 2
  1. 1.Unité de BiostatistiquesFrance
  2. 2.Laboratoire de PhysiopathologieInstitut CurieFrance
  3. 3.UniversitéParisFrance

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