Prognostic value of steroid receptors after long-term follow-up of 2257 operable breast cancers

• Published in: British journal of cancer Vol. 73; no. 12; pp. 1545 - 1551
• Main Authors: PICHON, M. F, BROET, P, ASSELAIN, B, MAGDELENAT, H, DELARUE, J. C, SPYRATOS, F, BASUYAU, J. P, SAEZ, S, RALLET, A, COURRIERE, P, MILLON, R
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.06.1996
• Subjects: Adult; Aged; Aged, 80 and over; Analysis of Variance; Biological and medical sciences; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Breast Neoplasms - ultrastructure; Female; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Mammary gland diseases; Medical sciences; Middle Aged; Neoplasm Metastasis; Prognosis; Radioligand Assay; Receptors, Estrogen - analysis; Receptors, Progesterone - analysis; Risk Factors; Time Factors; Tumors; Human; Mammary gland diseases; Prognosis; Follow up study; Estrogen; Mammary gland; Progesterone; Malignant tumor; Sex steroid hormone; Ovarian hormone; Hormonal receptor
• DOI: 10.1038/bjc.1996.291
• ISSN: 0007-0920

The prognostic value of oestrogen receptor (ER) and progesterone receptor (PR) was estimated through a multicentric study of 2257 operable breast cancer patients followed up for a median of 8.5 years. None of the patients had received adjuvant therapy. The series included 33.3% stage I patients, 57.1% stage II, 5.7% stage IIIa and 2.4% stage IIIb. At the end point of the study 589 metastases and 537 deaths from cancer were recorded. Receptor measurements were performed by radiolgand assay according to a uniform protocol. A total of 68.8% of the tumous were ER positive and 54.0% PR positive ( > or = 10 fmol mg-1 cytosol protein). In univariate analysis, ER and PR status (positive/negative) were of prognostic value (P < 0.001) for the disease-free interval (DFI), the metastases-free interval (MFI) and the overall survival (OS). The OS of the patients after a first metastasis was also significantly different between ER-positive and -negative tumours (P < 0.001). In multivariate analysis (Cox proportional hazard model, 1665 patients), only the ER status showed a significant difference (P < 0.01) between positive and negative groups regarding the DFI, MFI and OS. By using Cox non-proportional, time-dependent models, we show that the predictive value of ER status of the primary tumour decreases by approximately 20% per year, losing its significance after 8 years of follow-up. Overall, when compared with TNM and histological grading, ER and PR status have a low prognostic value, their major interest remaining solely in the domain of therapeutic decision.