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Progesterone receptor activity and relapse-free survival in patients with primary breast cancer: The role of adjuvant chemotherapy

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Abstract

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.

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References

  1. Pichon MF, Pallud C, Brunet M, Milgrom E: Relationship of presence of progesterone receptors to prognosis in early breast cancer. Cancer Res 40: 3357–3360, 1980

    PubMed  Google Scholar 

  2. Clark GM, McGuire WL, Hubay CA, Pearson OH, Marshall JS: Progesterone receptor as a prognostic factor in stage II breast cancer. N Engl J Med 309: 1343–1347, 1983

    PubMed  Google Scholar 

  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, 1984

    Google Scholar 

  4. Howat JMT, Harris M, Swindell R, Barnes DM: The effect of oestrogen and progesterone receptors on recurrence and survival in patients with carcinoma of the breast. Br J Cancer 51: 263–270, 1985

    PubMed  Google 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, 1985

    PubMed  Google Scholar 

  6. Koenders AJ, Geurts-Moespot J, Kho KH, Benraad ThJ: Estradiol and progesterone receptor activities in stored lyophilized target tissue. J Steroid Biochem 9: 947–950, 1978

    PubMed  Google Scholar 

  7. Gehan E: A generalized Wilcoxon test for comparing arbitrarily single censored samples. Biometrika 52: 203–224, 1965

    PubMed  Google Scholar 

  8. Mantel N: Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother Rep 50: 163–170, 1966

    PubMed  Google Scholar 

  9. Cox DR: Regression models and life-tables. J R Stat Soc 34: 187–200, 1972

    Google Scholar 

  10. Dixon WJ (ed): BMDP statistical software. Berkeley California Press, 1983

  11. Allegra JC, Lippman ME, Simon R, Thompson EB, Barlock A, Green L, Huff KK, Do HMT, Aitken SL, Warren R: Association between steroid hormone receptor status and disease-free interval in breast cancer. Cancer Treat Rep 63: 1271–1277, 1979

    PubMed  Google Scholar 

  12. Howat JMT, Barnes DM, Harris M, Swindell R: Association of cytosol oestrogen and progesterone receptors with histological features of breast cancer and early recurrence of disease. Br J Cancer 47: 629–640, 1983

    PubMed  Google Scholar 

  13. Mason BH, Holdaway IM, Mullins PR, Yee LH, Kay RG: Progesterone and estrogen receptors as prognostic variables in breast cancer. Cancer Res 43: 2985–2990, 1983

    PubMed  Google Scholar 

  14. Saez S, Cheix F, Asselain B: Prognostic value of estrogen and progesterone receptors in primary breast cancer. Breast Cancer Res Treat 3: 345–354, 1983

    PubMed  Google Scholar 

  15. Alanko A, Heinonen E, Scheinin TM, Tolppanen EM, Vihko RV: Oestrogen and progesterone receptors and disease free interval in primary breast cancer. Cancer 50: 667–672, 1984

    PubMed  Google Scholar 

  16. Di Fronzo G, Cappelletti V, Coradini D, Ronchi E, Scavone G: Prognostic significance of progesterone receptors alone or in association with estrogen receptors in human breast cancer. Tumori 70: 159–164, 1984

    PubMed  Google 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, 1986

    Google Scholar 

  18. Kohail HM, Elias EG, El-Nowiem SA, Bashirelahi N, Didolkar MS, Reed WP: A multifactorial analysis of steroid hormone receptors in stage I and II breast cancer. Ann Surg 201: 611–617, 1985

    PubMed  Google Scholar 

  19. Caldarola GL, Volterrani P, Caldarola B, Lai M, Jayme A, Gaglia P: The influence of hormone receptors and hormonal adjuvant therapy on disease-free survival in breast cancer: a multifactorial analysis. Eur J Cancer Clin Oncol 22: 151–155, 1986

    PubMed  Google Scholar 

  20. Thorpe SM, Rose C, Rasmussen B, King WJ, De Sombre ER, Blough RM, Mouridsen HT, Rossing N, Andersen KW: Steroid hormone receptors as prognostic indicators in primary breast cancer. Breast Cancer Res Treat 7 (Suppl): 91–99, 1986

    PubMed  Google Scholar 

  21. Kinne DW, Ashikari R, Butler A, Menendez-Botet C, Rosen PP, Schwartz M: Estrogen receptor protein in breast cancer as a predictor of recurrence. Cancer 47: 2364–2367, 1981

    PubMed  Google Scholar 

  22. von Maillot K, Horke W, Prestele H: Prognostic significance of the steroid receptor content in primary breast cancer. Arch Gynecol 231: 185–190, 1982

    PubMed  Google Scholar 

  23. Kaufmann M, Klinga K: Mögliche prognostische Kriterien zur Therapie-Verbesserung beim primären Mammakarzinom. Geburtsh u Frauenheilk 42: 501–509, 1982

    Google Scholar 

  24. Stewart JF, Rubens RD, Millis RR, King RJB, Hayward JL: Steroid receptors and prognosis in operable (stage I and II) breast cancer. Eur J Cancer Clin Oncol 19: 1381–1387, 1983

    PubMed  Google Scholar 

  25. Vollenweider-Zerargui L, Barrelet L, Wong Y, Lemarchand-Béraud T, Gomez F: The predictive value of estrogen and progesterone receptors' concentrations on the clinical behavior of breast cancer in women. Cancer 57: 1171–1180, 1986

    PubMed  Google 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, 1983

    PubMed  Google 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, 1983

    Google Scholar 

  28. Pascual MR, Macias A, Moreno L, Lage A: Factors associated with prognosis in human breast cancer. V. The simultaneous use of estrogen and progesterone receptor measurements for prediction of short-term relapse. Neoplasma 32: 247–256, 1985

    PubMed  Google Scholar 

  29. Bonadonna G, Valagussa R, Rossi A, Tancini G, Brambilla C, Zambetti M, Veronesi U: Ten-year experience with CMF-based adjuvant chemotherapy in resectable breast cancer. Breast Cancer Res Treat 5: 95–117, 1985

    PubMed  Google Scholar 

  30. Padmanabhan N, Howell A, Rubens RD: Mechanism of action of adjuvant chemotherapy in early breast cancer. Lancet ii: 411–415, 1986

    Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Division of Endocrinology, University Hospital Nijmegen, Geert Grooteplein Zuid 8, Nijmegen, The Netherlands

    J. M. M. Raemaekers, L. V. A. M. Beex, G. F. F. M. Pieters, A. G. H. Smals & P. W. C. Kloppenborg

  2. Department of Experimental and Chemical Endocrinology, University Hospital Nijmegen, Nijmegen, The Netherlands

    Th. J. Benraad

  3. Department of Surgery, University Hospital Nijmegen, Nijmegen, The Netherlands

    T. Wobbes

  4. Department of Radiotherapy, University Hospital Nijmegen, Nijmegen, The Netherlands

    W. van Daal

  5. Department of Pathology, University Hospital Nijmegen, Nijmegen, The Netherlands

    R. Holland

  6. Department of Radiology, University Hospital Nijmegen, Nijmegen, The Netherlands

    J. Hendriks

  7. Department of Medical Oncology, University Hospital Nijmegen, Nijmegen, The Netherlands

    D. Wagener

Authors
  1. J. M. M. Raemaekers
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  2. L. V. A. M. Beex
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  3. G. F. F. M. Pieters
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  4. A. G. H. Smals
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  5. Th. J. Benraad
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  6. P. W. C. Kloppenborg
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  7. T. Wobbes
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  8. W. van Daal
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  11. D. Wagener
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Raemaekers, J.M.M., Beex, L.V.A.M., Pieters, G.F.F.M. et al. Progesterone receptor activity and relapse-free survival in patients with primary breast cancer: The role of adjuvant chemotherapy. Breast Cancer Res Tr 9, 191–199 (1987). https://doi.org/10.1007/BF01806379

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