Estrogen receptor beta protein in human breast cancer: correlation with clinical tumor parameters

The recent discovery of a second estrogen receptor (ER), designated ERbeta, raises pressing questions about its role in estrogen regulation of human breast cancer cells and its significance for the prediction of recurrence and treatment responses in clinical breast cancer. Most of what we know about ERbeta expression comes from studies examining a limited number of samples at the RNA level. We have now generated a monoclonal antibody useful for the detection of ERbeta at the protein level in archival, formalin-fixed breast tumors and have examined its expression using immunohistochemistry in a pilot series of 242 breast cancer patients. Coexpression of ERbeta and ERalpha was found in the majority of the tumors, with 76% of the tumors expressing ERbeta as determined by immunohistochemistry. ERalpha, but not ERbeta, was strongly associated with progesterone receptor expression, suggesting that ERalpha is the predominant regulator of this estrogen-induced gene in breast tumors. Although ERalpha expression was positively correlated with low tumor grade, diploidy, and low S-phase fraction, all biological parameters of a good prognostic profile, ERbeta trended toward an association only with aneuploidy; no association with tumor grade or S-phase fraction was seen for ERbeta. We found that ERbeta expression does cause false positive readings for ERalpha. These results suggest that ERbeta expression is not a surrogate for ERalpha in clinical breast tumors and, as such, could be a useful biomarker in its own right.