单激素受体阳性乳腺癌患者的临床病理特征及预后因素分析

目的分析雌激素或孕激素受体阳性即单激素受体阳性乳腺癌患者的临床病理特征及预后因素,比较两种单激素受体阳性即ER单阳性和PR单阳性乳腺癌患者的不同之处。方法2000年9月至2002年9月在我院就诊的Ⅰ～Ⅲ。期单激素受体阳性乳腺癌患者共112例,分析其临床病理特征及预后因素。结果全组患者5年生存率（OS）为89．0％,5年无病生存率（DFS）为79．8％。COX多因素预后分析显示,腋窝淋巴结转移数目是全组患者的独立预后因素（P=0．003）,脉管瘤栓是淋巴结阴性单激素受体阳性患者DFS的独立预后因素（P=0．038）。PR单阳性组年龄≤50岁（P=0．021）以及绝经前患者（P=0．033）显著多于ER单阳性组。PR单阳性组分级3级、肿瘤直径〉2cm、脉管瘤栓者的比例略高于ER单阳性组,但无统计学意义。内分泌治疗可显著改善ER单阳性组患者的OS（P=0．04）及DFS（P=0．000）。内分泌治疗有一定程度上提高了PR单阳性组患者的OS（P=0．271）及DFS（P=0．387）。结论腋窝淋巴结转移数目是全组患者的独立预后因素。内分泌治疗可显著改善ER单阳性组患者的生存,有改善PR单阳性组患者生存的趋势。     

乳腺癌原发灶与腋淋巴结转移灶ER和PR及c-erbB-2表达的对照研究

目的:研究雌激素受体(ER)、孕激素受体(PR)和c-erbB-2在乳腺癌原发灶和同期腋淋巴结转移灶之间的表达差异。方法:免疫组织化学方法检测60例初治单侧乳腺癌同期腋窝淋巴结转移手术治疗患者ER、PR和c-erbB-2在原发灶及腋淋巴结转移灶的表达差异。结果:ER在乳腺癌原发灶中的阳性率为56.7%(34/60),腋淋巴结转移灶中为48.3%(29/60);PR在乳腺癌原发灶中的阳性率为55.0%(33/60),腋淋巴结转移灶为48.3%(29/60);c-erbB-2在乳腺癌原发灶中的阳性率为26.7%(16/60),腋淋巴结转移灶为28.3%(17/60);ER、PR和c-erbB-2的阳性率在两者之间的差异均无统计学意义。ER在原发灶和腋窝淋巴结转移灶之间总的变化率为21.7%(13/60),PR为16.7%(10/60),c-erbB-2为15.0%(9/60)。结论:ER、PR和c-erbB-2的表达在乳腺癌原发灶和腋窝淋巴结转移灶之间存在不一致现象,但无统计学意义。判断乳腺癌的预后要综合考虑其原发灶和转移灶的生物学特性。     

术前化疗对乳腺癌组织激素受体及耐药基因蛋白表达的影响

  目的  探讨术前化疗对乳腺癌组织激素受体及耐药基因蛋白表达的影响。   方法  收集2009年1月至2011年12月在江苏省肿瘤医院行术前化疗并手术治疗的92例乳腺癌患者临床资料,对化疗前B超引导下经皮粗针穿刺活检乳腺癌组织以及手术标本采用免疫组织化学SP法检测ER、PR、P-gp、GST-π、TOPO-Ⅱ的表达,比较化疗前后表达差异。   结果   经术前化疗后,ER、PR的阳性表达分别由65.2%、56.5%降为50.0%、52.2%,其中ER表达差异具有统计学意义（P < 0.05）。P-gp、GST-π的表达分别由54.3%、32.6%增高到82.6%、45.7%,前后比较差异具有统计学意义（P < 0.05）,同时两者共表达的乳腺癌患者由化疗前的22例增加为32例,TOPO-Ⅱ的阳性表达则由化疗前的48.9%降为41.3%,前后差异无统计学意义（P>0.05）。   结论  术前化疗影响乳腺癌组织中激素受体及耐药基因蛋白的表达,监测其表达对于选择药物、判断预后以及指导治疗具有参考价值。      

乳腺癌多原发癌的临床病理特征及预后分析

  目的   探讨乳腺癌多原发癌（multiple primary cancers,MPCs）患者的临床病理特征及预后因素。   方法   回顾性分析2005年1月至2015年12月天津医科大学肿瘤医院收治的226例乳腺癌MPCs患者的临床病理资料,应用单因素及多因素分析方法分析其临床病理学特征及影响预后的因素。   结果   226例中74例（32.7%）为同时型MPCs,152例（67.3%）为异时型MPCs。在第二原发恶性肿瘤中甲状腺癌最常见,为90例。患者的中位随访时间为84.75（4.1~384.5）个月,226例患者的3年及5年总生存率分别为91.7%和82.9%。乳腺癌MPCs患者的病理特征以肿瘤负荷大（65.5% vs. 34.5%,P=0.005）和ER受体阳性（76.1% vs. 23.9%,P=0.046）多见,异时型MPCs更倾向于高龄人群（62.4% vs. 37.6%,P < 0.001）。无淋巴结转移（95%CI:0.341~0.932,P=0.025）和异时型MPCs（95%CI:0.033~0.220,P < 0.001）患者预后佳。   结论   甲状腺是最常见的第二原发肿瘤,肿瘤负荷大及ER受体阳性患者易发生乳腺癌MPCs,高龄患者易患异时型MPCs,有无淋巴结转移和MPCs的类型是患者预后的独立影响因素。      

细胞周期蛋白D1在浸润性乳腺癌中的表达及其临床意义

目的　探讨浸润性乳腺癌组织中细胞周期蛋白D 1(cyclinD1)的表达 ,及其与激素受体和临床病理特征的相关性。方法　采用免疫组化方法检测 97例浸润性乳腺癌组织和 2 0例正常乳腺组织中cyclinD1的表达情况 ;采用免疫组化方法检测肿瘤组织中的雌、孕激素受体 (ER、PR)的表达。结果　浸润性乳腺癌组织中 ,cyclinD1蛋白表达率 (5 7.7% )显著高于正常乳腺组织(15 .0 % ) (P <0 .0 1)。ER阳性、PR阳性的乳腺癌组织中cyclinD 1表达较ER阴性、PR阴性者增高。cyclinD 1高表达与腋淋巴结转移、肿瘤大小、TNM分期显著相关 ,而与患者年龄、肿瘤病理类型无关。结论　cyclinD1的高表达在乳腺癌的发生、发展中可能起重要作用 ,并与激素受体、腋淋巴结转移、TNM分期相关     

乳腺癌雌、孕激素受体与腋淋巴结转移的关系

目的探讨乳腺癌雌、孕激素受体(ER、PR)与淋巴结转移之间的关系.方法应用免疫组织化学方法对257例乳腺癌组织石蜡切片进行ER、PR检测,将ER、PR结果与病理检出淋巴结的结果进行统计学分析.结果 ER、PR的阳性表达率分别为63.27%和59.27%.在ER、PR的4种组合中淋巴结转移率基本相同,经统计学处理均无显著差异(P＞0.05).结论乳腺癌组织中的ER、PR阳性表达与淋巴结转移无关.ER、PR测定对指导内分泌治疗和估计预后有重要意义.     

ERβ在乳腺癌组织中的表达及与临床病理因素的关系

目的　探讨ERβ在乳腺癌组织中的表达及其与临床病理因素的关系。 方法　采用免疫组化S -P法测定 97例原发性乳腺癌组织中ERα、ERβ和PR的表达 ,并与生化法测得的ER、PR及临床病理指标作对比分析。 结果　ERβ在原发性乳腺癌组织中阳性表达率为 62 .9% ( 61/ 97)。ERβ与ERα的表达无相关性 (P >0 .0 5 )。ERα、生化ER、PR及免疫组化PR均阴性表达的乳腺癌组织内ERβ阳性表达率为 83 .3 % ( 10 / 12 )。ERβ阳性表达与组织学分级呈负相关 (P <0 .0 1)。无腋淋巴结转移者的ERβ阳性表达率为 81.6% ( 3 1/ 3 8) ,有腋淋巴结转移者的ERβ阳性表达率为 5 0 .8% ( 3 0 / 5 9) ,两者具有非常显著性差异 (P <0 .0 1) ,且ERβ阳性表达与腋淋巴结转移呈负相关。ERβ表达与患者年龄、肿瘤大小、临床分期、月经状况和病理类型无明显相关 (P >0 .0 5 )。结论　ERβ与ERα、PR一样也为细胞核受体。原发性乳腺癌组织内亦有ERβ表达。在原发性乳腺癌组织内ERβ阳性表达与组织学分级和腋淋巴结转移呈负相关。ERβ与ERα的表达无相关性 ,不能通过ER、PR及ERα联合测定来取代ERβ的检测。     

瑞宁得治疗高龄晚期转移性乳腺癌一例

内分泌治疗是乳腺癌一种重要而独立的治疗手段,对激素受体阳性的复发转移乳腺癌疗效明确。我院治疗1例79岁双乳腺癌术后晚期肺转移患者,取得了较好疗效,现报告如下。 患者,女,79岁。于1998年5月行右乳腺癌根治术,术后病理证实为浸润性导管癌,ER(-)、PR(-)、HERZ(+),腋淋巴结阴性(0/8),曾行CMF辅助化疗。2000年1月发现左乳肿块,再次行左乳腺癌改良根治术。术后病理示浸润性导管癌,ER(++),PR(+),腋淋巴结阴性。于2000年1月～2001年11月服三苯氧胺辅助治疗。2001年11月发现肺转     

ER、PR和EphA2在乳腺癌中的表达及临床意义

目的探讨乳腺癌组织中雌激素受体（ER）、孕激素受体（PR）和EphA2基因的表达及其与淋巴结转移、临床分期的关系及联合检测对乳腺癌术后治疗方案的制定和在预后中的意义。方法采用S-P免疫组化方法检测130例乳腺癌患者ER、PR和EphA2的表达,并结合临床病理因素进行分析。结果（1）乳腺癌组织中ER、PR和EphA2的阳性表达率分别为63.1%、58.4%和72.3%。（2）ER、PR的阳性表达与乳腺癌患者的年龄、病理组织学类型、肿瘤大小、腋窝淋巴结转移和临床分期无显著相关（P〉0.05）;（3）EphA2阳性表达与乳腺癌患者的年龄、肿瘤大小、病理组织学类型无显著相关（P〉0.05）;而与腋窝淋巴结转移、临床分期显著相关（P〈0.05）。（4）EphA2的阳性表达率在乳腺癌ER／PR阴性组明显高于乳腺癌ER／PR阳性组（P〈0.05）。结论ER、PR和EphA2与乳腺癌的发生、发展有关,联合检测ER、PR和EphA2有助于客观评估乳腺癌的生物学行为,有助于指导临床用药和预测预后。     

乳腺癌组织中bcl-xl基因与雌孕激素受体表达及意义

目的探讨乳腺癌组织中bel-xl基因的表达与雌孕激素受体表达的关系及意义。方法采用免疫组化S-P法检测70例乳腺癌组织中bel-xl、雌激素受体（ER）、孕激素受体（PR）的表达。结果bel-xl、ER、PR在乳腺癌组织中的表达阳性率分别为61．43％、62．86％和55．71％。bel-xl的表达在ER阴性组高于ER阳性组（P〈0．05），其阳性率分别为76．92％和52．27％；在PR阴性组高于PR阳性组（P〈0．05），其阳性率分别为77．42％和48．72％；在有淋巴结转移组高于无淋巴结转移组（P〈0．05），其阳性率分别为64．58％和36．36％。结论bel-xl与ER、PR的联合检测是判断乳腺癌患者预后的重要指标，也为乳腺癌患者术后的个性化放化疗提供指导意义。     

The Case to Case Comparison of Hormone Receptors and HER2 Status between Primary Breast Cancer and Synchronous Axillary Lymph Node Metastasis

Background: Nowadays, the adjuvant treatment for breast cancer patients chosen depends on immunohistochemical pattern of Estrogen receptor(ER), Progesterone receptor(PR) and HER2 status of primary breast tumor. Several retrospective studies showed significant discordance in receptor expression between primary and metastatic tumors. The objective of this research was to determine discordant rate of ER, PR and HER2 status between primary breast cancer and synchronous axillary lymph node metastasis of individual breast cancer patients in Thammasat University Hospital. Methods: A prospective observational study of all breast cancer patients who have axillary metastasis and underwent surgery at Thammasat Hospital between January 2011 to December 2015. Tumor staging, ER, PR, and HER2 status on primary breast tumor were recorded. Synchronous axillary lymph node metastasis was evaluated with immunohistochemistry for ER, PR, and HER2. Results: The ER-positive rate from primary tumor to synchronous axillary lymph node metastasis decreased from 74.7% to 71.7%; the HER2 overexpression rate was decreased from 26% to 24%. In contrast, PR positive rate were 71% in both primary tumor and synchronous axillary lymph node metastasis. In case to case comparison, discordance rate of ER, PR and HER2 status between primary breast cancer and synchronous axillary lymph node metastasis were 11.1%, 20.2% and 10.1%, respectively. Furthermore, the tumor staging was not significant associated with discordance of ER, PR and HER2. Conclusion: ER, PR and HER 2 biomarkers showed significant concordance between primary tumor and synchronous axillary lymph node metastasis. Hence, if we cannot assess the ER, PR and HER2 status in primary tumor, then synchronous axillary lymph node metastasis can be studied instead. However, the repeat of biomarker testing in node-positive breast cancer patients may be beneficial for tailored adjuvant therapy, especially for patients with negative hormone receptor and/or HER2 profile on primary tumor.     

Impact of metastatic estrogen receptor and progesterone receptor status on survival

Summary Hormone responsive breast cancer is usually determined by the presence of estrogen receptors (ER) or progesterone receptors (PR) on primary invasive breast cancers. Adjuvant and metastatic hormone therapy are recommended based on primary ER and PR determination. Little information is available to determine if primary hormone receptors correlate with metastatic disease and if survival is influenced by metastatic receptor status. We retrospectively compared primary to metastatic tumor ER and PR content from 200 metastatic breast cancer patients. ER and PR analyses were available in both primary and metastatic disease in 200 and 173 patients, respectively. There was a correlation between both the ER and PR in the primary and metastatic lesion (p < 0.001). However, in 60 of 200 (30%) patients, discordance between primary and metastatic ER was noted. Tumors from 68 of 173 (39.3%) showed discordance for PR. In 39 (19.5%) patients, the ER primary status was positive and metastatic status was negative and in 21 (10.5%) patients, the primary status was negative and metastatic status was positive. Survival from the time of metastatic diagnosis was calculated. Those patients with ER positive primary and metastatic tumors (Positive/Positive) or only the metastatic lesion (Negative/Positive) had similar median survival (1131 and 1111 days, respectively). However, patients with tumors that changed from positive primary to negative metastasis (Positive/Negative) experienced significantly shorter median survival (669 days, p < 0.05). Likewise, median survival (580 days) was significantly shorter for patients with primary and metastasis ER negative (Negative/Negative, p < 0.001) compared to Positive/Positive (p < 0.001) or compared to Negative/Positive (p < 0.02). The changes in PR status were not associated with a change in survival. We found a significant discordance between hormone receptor content of primary versus metastatic breast cancer. The ER status of the metastatic lesion was a better predictor of survival. Therefore, optimal metastatic treatment cannot be determined solely on primary ER and PR analysis.     

乳腺癌原发灶和转移灶激素受体与HER2表达差异及其影响因素

目的 乳腺癌的治疗已经进入分子分型时代,雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)和人类表皮生长因子受体-2(human epidermal growth factor receptor 2,HER2)的表达对指导制订乳腺癌治疗方案及评价患者预后等尤为重要.许多研究证实,部分乳腺癌患者原发灶及转移灶激素受体与HER2表达存在差异,影响术后辅助及解救治疗方案的制订,进而影响患者的治疗效果及预后.本研究探讨乳腺癌原发灶与腋窝及远处转移灶之间激素受体与HER2表达的差异及其临床意义,同时分析了造成差异的影响因素.方法 以乳腺癌、激素受体(ER和PR)、HER2、原发灶和转移灶为关键词,检索PubMed、CNKI数据库和万方数据库1995-01-2016-10的相关文献.共505篇文章被检索到.纳入标准:原发灶与腋窝转移灶激素受体及HER2表达差异情况,原发灶与远处转移灶激素受体及HER2表达差异情况,原发灶与转移灶激素受体及HER2表达差异情况的临床意义.根据纳入标准最终纳入分析38篇文献.结果 在部分乳腺癌患者中,原发灶与腋窝转移灶及远处转移灶激素受体及HER2表达情况存在差异,多数文献报道,乳腺癌原发灶与转移灶ER表达状况变化(阳性转阴性或阴性转阳性)比例约为20％,PR约为20％,HER2约为15％.“肿瘤异质性、抗肿瘤治疗和检测方法”等是影响其表达差异的影响因素.结论 推荐对于存在局部及远处转移的乳腺癌患者,同时检测并综合原发灶及转移灶的激素受体及HER2表达情况制订治疗方案.     

胱蛋白M在乳腺癌及其转移癌中的表达和临床意义

  目的   探讨胱蛋白M（Cystatin M）在乳腺癌及转移癌中的表达和临床意义。   方法  采用RT-PCR检测108例乳腺癌标本,30例转移癌标本及24例癌旁正常乳腺组织中Cystatin M mRNA,分析Cystatin M基因表达与临床病理参数和预后的关系。   结果  乳腺癌标本中Cystatin M表达水平在Ⅰ/Ⅱ期乳腺癌患者中较高,而在Ⅲ/Ⅳ期乳腺癌患者中较低,差异有统计学意义;Cystatin M在5 cm以下肿瘤中表达较高,而在5 cm以上肿瘤中表达较低,差异有统计学意义;乳腺癌标本中Cystatin M表达与正常乳腺组织中Cystatin M表达差异无统计学意义;乳腺癌标本中Cystatin M与转移癌标本中Cystatin M表达差异无统计学意义;乳腺癌标本中Cystatin M表达水平与乳腺癌患者是否发生淋巴结转移,淋巴结转移数,组织学分级,病理学类型无相关性;乳腺癌标本中Cystatin M表达水平和转移癌标本中Cystatin M表达水平与人表皮生长因子受体2状态（HER-2）,雌激素受体状态（ER）及孕激素受体状态（PR）无相关性;乳腺癌标本中Cystatin M表达较高的组患者中位总生存期比Cystatin M表达较低的组患者中位总生存期要长,两者之间差异无统计学意义。   结论  Cystatin M为监测乳腺癌发生浸润转移的可靠指标仍需探讨。      

乳腺癌患者胸肌间淋巴结转移的影响因素及手术清扫

  目的   分析乳腺癌患者胸肌间淋巴结（IPNs）的检出率、转移率及其影响因素,探讨胸肌间淋巴结清扫的意义和指征。   方法   回顾性分析1 673例接受乳腺癌改良根治术并且胸肌间淋巴结单独送病理检查患者的病理临床资料,记录IPNs的检出率和转移情况,分析IPNs转移与肿瘤大小、腋窝淋巴结、临床分期、新辅助化疗、激素受体、Her-2表达以及乳腺癌分子亚型的关系。   结果   本组病例IPNs检出率、IPNs总体转移率、腋窝淋巴结阳性者IPNs转移率分别为13.39%、4.3%和10.01%。IPNs转移率与腋窝淋巴结转移、肿瘤TNM分期之间具有显著相关性（P < 0.05）,但与激素受体状况、Her-2表达以及乳腺癌分子亚型之间未见相关（P>0.05）;新辅助化疗并未降低肿瘤局部偏晚患者的IPNs转移率;IPNs转移者表现为肿瘤较大、腋窝淋巴结转移多、TNM分期较晚。   结论   IPNs转移多见于肿瘤直径较大、腋窝淋巴结转移、TNM分期较晚、局部晚期以及适合新辅助化疗的乳腺癌患者,这些指征可能意味着需要常规进行IPNs的手术清扫和单独送检。      

Prognostic impact of discordance between triple-receptor measurements in primary and recurrent breast cancer

BackgroundWe evaluated discordance in expression measurements for estrogen receptor (ER), progesterone receptor (PR), and HER2 between primary and recurrent tumors in patients with recurrent breast cancer and its effect on prognosis.MethodsA total of 789 patients with recurrent breast cancer were studied. ER, PR, and HER2 status were determined by immunohistochemistry (IHC) and/or FISH. Repeat markers for ER, PR, and HER2 were available in 28.9%, 27.6%, and 70.0%, respectively. Primary and recurrent tumors were classified as triple receptor-negative breast cancer (TNBC) or receptor-positive breast cancer (RPBC, i.e. expressing at least one receptor). Discordance was correlated with clinical/pathological parameters.ResultsDiscordance for ER, PR, and HER2 was 18.4%, 40.3%, and 13.6%, respectively. Patients with concordant RPBC had significantly better post-recurrence survival (PRS) than discordant cases; patients with discordant receptor status had similarly unfavorable survival as patients with concordant TNBC. IHC scores for ER and PR showed weak concordance between primary and recurrent tumors. Concordance of HER2–FISH scores was higher.ConclusionsConcordance of quantitative hormone receptor measurements between primary and recurrent tumors is modest consistent with suboptimal reproducibility of measurement methods, particularly for IHC. Discordant cases have poor survival probably due to inappropriate use of targeted therapies. However, biological change in clinical phenotype cannot be completely excluded.     

ER(-)PR(+)乳腺癌辅助内分泌治疗的疗效

背景与目的：孕激素受体（PR）状态是雌激素受体（ER）状态预测乳腺癌辅助内分泌治疗的补充，临床上推荐ER阳性（＋）或PR（＋）患者均可接受内分泌治疗。ER阴性（-）PR（＋）肿瘤应用辅助内分泌治疗的疗效如何还存在争议。本研究将探讨辅助内分泌治疗对ER（＋）PR（＋）与ER（-）PR（＋）乳腺癌的疗效，并研究ER（-）PR（＋）患者的临床病理特性及预后。方法：回顾了1991年1月-2001年12月间的1863位ER／PR资料可用的可手术乳腺癌患者资料，ER、PR均采用免疫组化法检测。中位随访48个月，比较ER（-）PR（＋）组（205例）和ER（＋）PR（＋）组（798例）接受或不接受辅助内分泌治疗（3～5年的他莫昔芬）的无病生存（DFS）和总生存（0s）的差异。结果：ER（-）PR（＋）患者占全部乳腺癌患者的11．0％，中位年龄49岁，肿块中值大小3．0cm，其中未绝经者比例高达63．9％。ER（-）PR（＋）组较ER（＋）PR（＋）组而言，腋淋巴结转移数高、肿块大、分期晚。ER（＋）PR（＋）组和ER（-）PR（＋）组未行内分泌治疗时，组间生存差异无显著性；内分泌治疗后，两组的生存率均有所提高，但ER（＋）PR（＋）组的预后比ER（-）PR（＋）组更好（DFS：P=0．016，OS：P=0．007）。多因素分析显示对ER（-）PR（＋）患者，仅有腋淋巴结状态是独立的预后指标。结论：辅助内分泌治疗对ER（＋）PR（＋）乳腺癌的疗效优于对ER（-）PR（＋）乳腺癌的疗效，ER（-）PR（＋）患者能从内分泌治疗中得到一定收益，但较有限。     

Alterations in Hormonal Receptor Expression and HER2 Status between Primary Breast Tumors and Paired Nodal Metastases: Discordance Rates and Prognosis

Background: We aimed to evaluate the estrogen receptor (ER), progesterone receptor (PR), and humanepidermal growth factor receptor 2 (HER2) expression discordance in matched pairs of primary breast cancerand lymph node metastasis specimens and determine the effect of discordance on prognosis. Materials andMethods: Among all patients diagnosed with lymph node metastases from 2004 to 2007, primary tumors andpaired lymph node metastases were resected from 209 patients. The status of ER, PR, and HER2 expressionwas analyzed immunohistochemically in 200, 194, and 193 patients, respectively. Discordance was correlatedwith prognosis. Results: Biomarker discordance between primary tumors and paired lymph node metastaseswas 25.0% (50/200) for ER status, 28.9% (56/194) for PR status, and 14.0% (27/193) for HER2 status. ERpositivity was a significant independent predictor of improved survival when analyzed in primary tumors andlymph node metastases. Patients with PR-positive primary tumors and paired lymph node metastases displayedsignificantly enhanced survival compared to patients with PR-positive primary tumors and PR-negative lymphnode metastases. Patients with ER- and PR-positive primary tumors and paired lymph node metastases whoreceived endocrine therapy after surgery displayed significantly better survival than those not receiving endocrinetherapy. Similalry treated patients with PR-negative primary tumors and PR-positive paired lymph nodemetastases also displayed better survival than those not receiving endocrine therapy. Conclusions: Biomarkerdiscordance was observed in matched pairs of primary tumors and lymph node metastases. Such cases displayedpoor survival. Thus, it is important to reassess receptor biomarkers used for lymph node metastases.     

Risk factors for hormone receptor-defined breast cancer in postmenopausal women.

The effect of classic breast cancer risk factors on hormone receptor-defined breast cancer is not fully clarified. We explored these associations in a Swedish population-based study. Postmenopausal women ages 50 to 74 years, diagnosed with invasive breast cancer during 1993 to 1995, were compared with 3,065 age frequency-matched controls. We identified 332 estrogen receptor (ER-) and progesterone receptor (PR-) negative, 286 ER+PR-, 71 ER-PR+, 1,165 ER+PR+, and 789 tumors with unknown receptor status. Unconditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (95% CI). Women ages >or=30 years, compared with those ages 20 to 24 years at first birth, were at an increased risk of ER+PR+ tumors (OR, 1.5; 95% CI, 1.2-1.8) but not ER-PR- tumors (OR, 1.1; 95% CI, 0.8-1.6). Women who gained >or=30 kg in weight during adulthood had an approximately 3-fold increased relative risk of ER+PR+ tumors (OR, 2.7; 95% CI, 1.9-3.8), but no risk increase of ER-PR- tumors (OR, 1.0; 95% CI, 0.5-2.1), compared with women who gained <10 kg. Compared with never users, women who used menopausal estrogen-progestin therapy for at least 5 years were at increased risk of ER+PR+ tumors (OR, 3.0; 95% CI, 2.1-4.1) but not ER-PR- tumors (OR, 1.3; 95% CI, 0.7-2.5). In conclusion, other risk factors were similarly related to breast cancer regardless of receptor status, but high age at first birth, substantial weight gain in adult age, and use of menopausal estrogen-progestin therapy were more strongly related to receptor-positive breast cancer than receptor-negative breast cancer.