Estrogen receptor cytochemistry in human breast cancer: status and prospects

Advances in knowledge of the endocrine control of neoplastic growth can be expected to stem directly from advances in pertinent techniques. Following this theme, the present paper describes how recent development in cytochemical techniques for estrogen receptors may maintain this expectation and lead to significant progress in the basic knowledge of breast cancer that can influence the treatment approach. Cytochemical techniques have shown that the binding of estrogen to target cells and tissues can be specifically visualized: moreover, estrogen binding sites characterized cytochemically under controlled conditions have proved to fulfill the accepted criteria for estrogen receptors. Some working solutions to basic questions concerning the tumor hormone-responsiveness have been provided and more precise explanations of fundamental growth-regulatory mechanisms are expected to emerge from the approach to breast cancer by cytologic endocrinology. However, in the present state of the art and in spite of tantalizing bits of data, cytochemical techniques for estrogen receptors do not seem extensible to routine purposes, as alternative to biochemical receptor assays in selecting patients for endocrine therapy. One must have strong reservations on their clinical use because of the almost complete lack of information about correlations of cytochemical results with the response to endocrine therapy. More studies evaluating the practical validity of estrogen receptor cytochemistry are required.