This summary table contains detailed information about research studies. While viewing summary tables offers an informative glimpse at the science behind many breast cancer guidelines and recommendations, they should be viewed with some caution. There are a number of concepts you must understand to be able to successfully read and interpret research tables. To get some background information about understanding research tables, please see How to Read a Research Table.
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Introduction: Estrogen receptor status is an important factor in planning treatment for breast cancer. Breast cancers that have a large number of estrogen receptors (called estrogen receptor-positive tumors) will respond to hormone treatments like tamoxifen and aromatase inhibitors. Estrogen receptor status is also an independent prognostic factor. It gives a sense of how aggressive the breast cancer may be. Estrogen receptor-positive tumors tend to be linked to better survival than tumors with few or no estrogen receptors (called estrogen receptor-negative tumors). As the studies below show, people with estrogen receptor-positive breast cancer tend to have about a 10 percent better overall survival five years after diagnosis than those with estrogen receptor-negative tumors. However, after five years, this survival difference begins to lessen and over time may even disappear [1,2]. As estrogen receptor-negative breast cancers tend to recur more quickly than estrogen receptor-positive cancers do, survival at 10 years after diagnosis may not differ.
HER2/neu (human epidermal growth factor receptor 2) status: HER2-positive status, also referred to as HER2/neu over-expression, is found in about 20 percent of all breast cancer [3]. HER2/neu-positive cancers tend to be more aggressive and have a worse prognosis. However, HER2/neu-positive cancers tend to be estrogen receptor-negative and both these factors are independent factors in prognosis. Therefore, studies of either factor should take into account the other. Find out more on HER2/neu status.
Find information on the strengths and weaknesses of different types of studies.
Study selection criteria: Prospective cohort studies with at least five years of follow-up and at least 500 participants.
| |
Study
|
Study Population
(number of participants)
|
Characteristics of Breast Cancer
|
Follow-up (months)
|
5-Year Overall Survival*
|
Estrogen Receptor-Positive
|
Estrogen Receptor-Negative
|
Prospective cohort studies
|
| Danish Breast Cancer Cooperative Group [2] |
26,944 |
Grade I, II or III |
57.6 |
85%† |
69%† |
| Truong et al. [4] |
8,038 |
T1-2, M0; Grade I, II, or III
|
48-67 |
Higher
survival Sig |
Lower
survival Sig |
San Antonio Data Base [5,6]
|
3,452
|
Stage I, II or III
|
40
|
84%
|
75%Sig
|
Crowe et al. [7]
|
1,392
|
Stage I or II
|
120
|
82%
|
70%Sig
|
NSABP [1]
|
1,157
|
Node-negative; tumor smaller than 4 cm
|
60
|
92%
|
82%Sig
|
Winstanley et al. [8]
|
767
|
Stage I or II
|
132
|
69%
|
62%NS
|
Crowe et al. [9]
|
501
|
Stage I; node-negative
|
89
|
94%
|
80%Sig
|
Sig = Statistically significant difference in survival.
NS = Not a statistically significant difference in survival.
cm = centimeter
* All numbers estimated from figures in the original articles.
† For the 3,591 women for whom 10-year survival data were available, 10-year survival was 68% among those with estrogen receptor-positive tumors and 57% among those with estrogen receptor-negative tumors.
References
1. Fisher B, Redmond C, Fisher ER, Caplan R. Relative worth of estrogen or progesterone receptor and pathologic characteristics of differentiation as indicators of prognosis in node-negative breast cancer patients: Findings from National Surgical Adjuvant Breast and Bowel Project Protocol B-06. J Clin Oncol. 6(7):1076-87, 1988.
2. Bentzon N, Düring M, Rasmussen BB, Mouridsen H, Kroman N. Prognostic effect of estrogen receptor status across age in primary breast cancer. Int J Cancer. 122(5):1089-94, 2008.
3. Carey LA, Perou CM, Livasy CA, et al. Race, breast cancer subtypes, and survival in the Carolina Breast cancer Study. JAMA. 295(21):24922502, 2006.
4. Truong PT, Bernstein V, Wai, E, et al. Age-related variations in the use of axillary dissection: A survival analysis of 8038 women with T1-ST2 breast cancer. Int J Radiat Oncol Biol Phys. 54(3):794-803, 2002.
5. Clark GM and McGuire WL. Steroid receptors and other prognostic factors in primary breast cancer. Seminars in Oncology. 15(2 Suppl 1):20-5, 1988.
6. McGuire WL, Tandon AK, Allred DC, et al. How to use prognostic factors in axillary node-negative breast cancer patients. Journal of the National Cancer Institute. 82(12):1006-1015, 1990.
7. Crowe JP, Gordon NH, Hubay CA, et al. Estrogen receptor determination and long term survival of patients with carcinoma of the breast. Surgery, Gynecology & Obstetrics. 173(4):273-8, 1991.
8. Winstanley J, Cooke T, George WD, et al. The long-term prognostic significance of oestrogen receptor analysis in early carcinoma of the breast. British Journal of Cancer. 64(1):99-101, 1991.
9. Crowe JP, Gordon NH, Hubay CA, et al. The interaction of estrogen receptor status and race in predicting prognosis for stage I breast cancer patients. Surgery. 100(4):599-605, 1986.
Updated 09/12/09
