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Author Spotlight: Advancing Early Detection and Treatment of Gastrointestinal Tumors
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Which threshold for ER positivity? a retrospective study based on 9639 patients.

M Yi1, L Huo, K B Koenig

  • 1Department of Surgical Oncology.

Annals of Oncology : Official Journal of the European Society for Medical Oncology
|February 25, 2014
PubMed
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Estrogen receptor (ER) positive breast cancer patients with 1%-9% positivity show poorer survival and may not benefit from endocrine therapy, unlike those with ≥10% ER positivity. Further research is needed for this subgroup.

Area of Science:

  • Oncology
  • Pathology
  • Endocrinology

Background:

  • Current guidelines suggest estrogen receptor (ER) positivity if ≥1% of tumor cells stain positive by immunohistochemistry.
  • Clinical practice often uses a 10% threshold, with limited data on optimal ER positivity thresholds for endocrine therapy efficacy.
  • This study investigates differences in patient, tumor, treatment, and survival based on ER-positivity thresholds of 1% and 10%.

Purpose of the Study:

  • To compare clinical and pathological characteristics of breast cancer patients based on ER-positivity thresholds of 1% and 10%.
  • To evaluate survival outcomes in breast cancer patients across different ER-positivity thresholds.
  • To assess the potential benefit of endocrine therapy in patients with low ER positivity (1%-9%).

Main Methods:

Keywords:
breast cancerestrogen receptorlow positivesurvival

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  • Retrospective analysis of 9639 primary breast carcinoma patients treated between 1990 and 2011.
  • Patients categorized into three groups: ER-positive ≥10%, ER-positive 1%-9%, and ER-negative (<1%).
  • Comparison of patient demographics, tumor characteristics, treatment, and survival rates among the defined groups.

Main Results:

  • 80.5% of tumors were ER-positive ≥10%, 2.6% were ER-positive 1%-9%, and 16.9% were ER-negative.
  • Patients with ER-positive 1%-9% tumors were younger and had more advanced disease compared to those with ER-positive ≥10% tumors.
  • ER-positive 1%-9% tumors showed worse survival rates than ER-positive ≥10% tumors, and similar survival rates to ER-negative tumors.

Conclusions:

  • Tumors with 1%-9% ER positivity exhibit distinct clinical and pathological features compared to those with ≥10% ER positivity.
  • Patients with ER-positive 1%-9% disease may not benefit from endocrine therapy, similar to ER-negative cases.
  • Further investigation is required to define the clinical benefit of endocrine therapy and molecular subtypes (basal or luminal) in the ER-positive 1%-9% breast cancer group.