The Clinical Significance of Hormonal Receptors in Breast Cancer

ABSTRACT

PURPOSE: Clinically, the detection of steroid hormone receptors, estrogen receptor (ER) and proges terone receptor (PR), has been used not only as a prognostic marker but also as a predictor of hormone response in breast-cancer patients. We performed this study to evaluate the clinical significance of hormone receptors in breast cancers in Korea. METHODS: We have collected data about hormonal receptors from breast-cancer patients of Kangnam St. Mary's Hospital, The Catholic University of Korea, since 1984. A total of 544 patients were followed up and their clinicopathological results were analyzed retrospectively by using medical records. The survival analysis was performed by using the Kaplan-Meier method. RESULTS: The mean age of the patients was 47.3 years, and the peak of age distribution was noted in the 5th decade. The premenopausal patients were 358 (65.8%), and the postmenopausal patients were 186 (34.2%). The median follow-up period was 4.5 years. The results of ER/PR status were as follows (+)/(+) in 191 patients (35.1%), (+)/(-) in 82 patients (15.1%), (-)/(+) in 74 patients (13.6%), and (-)/(-) in 197 patients (36.2%). The positive rates of ER and PR were 52% or 55% in premenopausal patients and 46% and 36% in postmenopausal patients, respectively. In the univariate analysis of the overall survival by the Log-rank test, the significant variables were stage (p=0.0004), node metastasis (p=0.0000), lymphatic invasion (p=0.0000), vein invasion (p=0.0558), ER (p=0.0397), PR (p=0.0538), adjuvant hormone therapy (p=0.0010), the duration of hormone therapy (p=0.0004). In the multivariate analysis of the overall survival by using the Cox regression test, the significant variables were ER (p=0.0070), adjuvant hormone therapy (p=0.0234), adjuvant chemotherapy (p=0.0493) and mean ingful results were noted in the duration of hormonal therapy (p=0.0629), lymphatic invasion (p=0.0752) and tumor size (p=0.1726). CONCLUSION: The results of this study suggest that the pattern of hormonal receptor status according to menopause status might be different from that of western patients and confirmed hormonal receptors as prognostic markers and predictors of hormone therapy in breast cancer.