Hajime Kuroda and Nozomi Muroi have contributed equally to this work.
The existence of progesterone receptor (PgR) expression in oestrogen receptor (ER)-negative breast carcinoma is controversial. Here, we re-evaluated ER-negative/PgR-positive (ER−/PgR+) carcinoma cases by immunohistochemical staining (IHC).
We selected patients who underwent surgery for primary breast carcinoma from our databases at Dokkyo Medical University Hospital and Kameda General Hospital. Among the 9844 patients, the largest series in Japan, 27 (0.3%) were initially diagnosed as ER−/PgR+ breast carcinomas and we re-evaluated by IHC.
The re-evaluated IHC showed that of the 27 patients with the initial results of ER−/PgR+, 12 were ER+/PgR+, 8 were ER−/PgR−, and 7 were ER−/PgR+. ER was negative in 12 of 27 patients (44.4%), and PgR was positive in 8 of 27 patients (29.6%). In our seven re-evaluated and confirmed as ER−/PgR+ cases, the staining proportions of tumor cells were 0% in ER and 1–69% (average 15.8%) in PgR. The average staining proportion of PgR in the re-evaluated ER−/PgR+ phenotype was lower than the initial diagnosis. Histological grading was as follows: grade I, one case; grade II, two cases; grade III, four cases. There were two lymph-node-positive cases.
The ER−/PgR+ phenotype was confirmed after re-evaluation of ER and PgR assessment by a different pathologist. We recommend that pathologists discuss with clinicians, or re-test and re-evaluate ER/PgR expression, particularly in low-grade carcinoma and with a high staining proportion of PgR in the ER−/PgR+ phenotype.
Maleki Z, Shariat S, Mokri M, Atri M. ER-negative /PR-positive breast carcinomas or technical artifacts in immunohistochemistry? Arch Iran Med. 2012;15:366–9. https://doi.org/10.1016/j.ctrv.2018.05.005. PubMed
Ravdin PM, Green S, Dorr TM, McGuire L, Fabian C, Pugh RP, et al. Prognostic significance of progesterone receptor levels in estrogen receptor-positive patients with metastatic breast cancer treated with tamoxifen: results of a prospective Southwest Oncology Group study. J Clin Oncol. 1992;10:1284–91. CrossRefPubMed
Hammond ME, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. Arch Pathol Lab Med. 2010;134:907–22. https://doi.org/10.1043/1543-2165-134.6.907. PubMedPubMedCentral
Hammond ME, Hayes DF, Dowsett M, Allred DC, Hagerty KL, Badve S, et al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol. 2010;28:2784–95. https://doi.org/10.1200/JCO.2009.25.6529. CrossRefPubMedPubMedCentral
Ahmed SS, Thike AA, Zhang K, Lim JC, Tan PH. Clinicopathological characteristics of oestrogen receptor negative, progesterone receptor positive breast cancers: re-evaluating subsets within this group. J Clin Pathol. 2017;70:320–6. https://doi.org/10.1136/jclinpath-2016-203847. CrossRefPubMed
Bogina G, Zamboni G, Sapino A, Bortesi L, Marconi M, Lunardi G, et al. Comparison of anti-estrogen receptor antibodies SP1, 6F11, and 1D5 in breast cancer: lower 1D5 sensitivity but questionable clinical implications. Am J Clin Pathol. 2012;138:697–702. https://doi.org/10.1309/AJCPLX0QJROV2IJG. CrossRefPubMed
Itoh M, Iwamoto T, Matsuoka J, Nogami T, Motoki T, Shien T, et al. Estrogen receptor (ER) mRNA expression and molecular subtype distribution in ER-negative/progesterone receptor-positive breast cancers. Breast Cancer Res Treat. 2014;143:403–9. https://doi.org/10.1007/s10549-013-2763-z. CrossRefPubMed
- Oestrogen receptor-negative/progesterone receptor-positive phenotype of invasive breast carcinoma in Japan: re-evaluated using immunohistochemical staining
- Springer Japan
- Breast Cancer
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