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Home > Understanding Breast Cancer > Breast Cancer Research > Table 36: Estrogen receptor status and overall survival

  


Table 36: Estrogen receptor status and overall survival

This summary table contains detailed information about research studies. Summary tables offer an informative look at the science behind many breast cancer guidelines and recommendations. However, they should be viewed with some caution. In order to read and interpret research tables successfully, it is important to understand some key concepts. Learn how to read a research table.

Introduction: Estrogen receptor status helps guide treatment for breast cancer. Breast cancers that have a large number of estrogen receptors (estrogen receptor-positive (ER+) tumors) can be treated with hormone therapies like tamoxifen and aromatase inhibitors.  

Estrogen receptor status is also a prognostic factor. ER+ tumors tend to be linked to better survival than tumors with few or no estrogen receptors (estrogen receptor-negative (ER-) tumors).  

As the studies below show, five-year survival is about 10 percent better for women with ER+ breast cancer than for those with ER- tumors. However, after five years, this survival difference begins to lessen and over time may even disappear [1,2]. As ER- breast cancers tend to recur earlier than ER+ cancers, survival at 10 years after diagnosis may not differ.  

Learn more about estrogen receptor status.   

HER2/neu (human epidermal growth factor receptor 2) status and estrogen receptor status 

Similar to estrogen receptor status, HER2/neu status helps guide breast cancer treatment. HER2/neu protein appears on the surface of some breast cancer cells. This protein is an important part of the pathway for cell growth and survival. HER2/neu-positive (HER2+) breast cancers have a lot of HER2/neu protein. About 15 to 20 percent of breast cancers are HER2+ [3].  

HER2+ cancers tend to be more aggressive and have a worse prognosis than other cancers [3]. HER2+ tumors also tend to be ER-. Because both HER2/neu status and estrogen receptor status are factors in prognosis, studies of either factor should take into account the other.  

Learn more about HER2/neu status.

Learn about the strengths and weaknesses of different types of studies.

Study selection criteria: Prospective cohort studies with at least 500 participants and at least five years of follow-up.  

Study 

Study Population
(number of participants)
 

Characteristics of Breast Cancer 

Follow-up
(years)
 

 Five-Year Overall Survival  

Estrogen Receptor-Positive 

Estrogen Receptor-Negative 

Prospective cohort studies 

SEER [4]

111,993

Stage I, II or III

8

Women younger than 40:
90%*Sig 


Women 40-49:
94%*Sig 


Women 50-59:
95%*Sig 


Women 60-69:
95%*Sig 


Women 70-74:
94%*Sig 

Women younger than 40:
78%*Sig  


Women 40-49:
81%*Sig  


Women 50-59:
81%*Sig 


Women 60-79:
81%*Sig 


Women 70-74:
80%*Sig 

Danish Breast Cancer Cooperative Group [2]

26,944

Grade I, II or III

5

85%† 

69%†

Truong et al. [5]

8,038

T1-2, M0

Grade I, II, or III

4-6

Higher
survival
Sig 

Lower
survival
Sig 

San Antonio Data Base [6,7]

3,452

Stage I, II or III

3

84%

75%Sig 

Crowe et al. [8]

1,392

Stage I or II

10

82%

70%Sig 

NSABP [1]

1,157

Node-negative

Tumor smaller than 4 cm

5

92%

82%Sig 

Winstanley et al. [9]

767

Stage I or II

11

69%

62%NS 

Crowe et al. [10]

501

Stage I

Node-negative

7

94%

80%Sig 

Sig = Statistically significant difference in survival
NS = No statistically significant difference in survival

cm = centimeter

* Rates are for breast cancer-specific survival (death due to breast cancer), not overall survival (death due to any cause).

† For the 3,591 women for whom 10-year survival data were available, 10-year survival was 68% among those with ER+ tumors and 57% among those with ER- 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. Yu KD, Wu J, Shen ZZ, Shao ZM. Hazard of breast cancer-specific mortality among women with estrogen receptor-positive breast cancer after five years from diagnosis: implication for extended endocrine therapy. J Clin Endocrinol Metab. 97(12):E2201-9, 2012.
  5. 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.
  6. Clark GM and McGuire WL. Steroid receptors and other prognostic factors in primary breast cancer. Semin Oncol. 15(2 Suppl 1):20-5, 1988.
  7. McGuire WL, Tandon AK, Allred DC, et al. How to use prognostic factors in axillary node-negative breast cancer patients. J Natl Cancer Inst. 82(12):1006-1015, 1990.
  8. Crowe JP, Gordon NH, Hubay CA, et al. Estrogen receptor determination and long term survival of patients with carcinoma of the breast. Surg Gynecol Obstet. 173(4):273-8, 1991.
  9. Winstanley J, Cooke T, George WD, et al. The long-term prognostic significance of oestrogen receptor analysis in early carcinoma of the breast. Br J Cancer. 64(1):99-101, 1991.
  10. 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 09/04/13