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Erschienen in: Journal of Cancer Research and Clinical Oncology 12/2017

09.09.2017 | Original Article – Cancer Research

Prognostic role of progesterone receptor expression in a population-based analysis

verfasst von: Adele Caldarella, Alessandro Barchielli

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 12/2017

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Abstract

Purpose

The role of progesterone (PR) expression in the management of breast cancer is controversial. The aim of this study is to evaluate the characteristics and prognosis of progesterone status among breast cancers patients in a population-based analysis.

Materials and methods

Through the Tuscan Cancer Registry data on all the invasive breast cancer cases diagnosed during the period 2004–2005 in the provinces of Florence and Prato, central Italy, were retrieved. Histological reports were re-examined to obtain information on the percentage of positive tumor cells for estrogen (ER), progesterone (PR) receptors, Ki67 marker and human epidermal growth factor 2 (HER2). Information on age, stage, differentiation grade were also obtained.

Results

Out of 1487 patients, 28% had PR− breast cancer. These patients were older (p 0.006) than PR+ cancer patients, with more frequently high Ki67 (p < 0.0001), HER2 + (p < 0.0001), ER− (p < 0.0001) tumoral expression. The ER+/PR+ subtype was the most represented (n.1053), while ER−/PR+ was the most rare (n.23); 210 cases (14.1%) ER+ PR− and 201 (13.5%) ER−/PR− cases were found. Analysis of survival by the Cox proportional hazards model showed an independent prognostic value of PR expression (p < 0.0001), also when estrogen, Ki67, HER2 status and age were included. The 5-year cancer-specific survival was 82.1, 86.5, 100, 92% for ER−/PR−, ER+/PR−, ER−/PR+, ER+/PR+ subtype, respectively.

Conclusions

Our study revealed significant differences in clinicopathological characteristics among breast cancer according to PR expression and confirmed its prognostic independent role, suggesting a role of PR in the improvement of breast cancer prognostic characterization.
Literatur
Zurück zum Zitat Bae SY, Kim S, Lee JH, Lee H, Kil WH, Kim SW, Lee JE, Nam SJ (2015) Poor prognosis of single hormone receptor-positive breast cancer: similar outcome as triple negative breast cancer. BMC Cancer 15:138CrossRefPubMedPubMedCentral Bae SY, Kim S, Lee JH, Lee H, Kil WH, Kim SW, Lee JE, Nam SJ (2015) Poor prognosis of single hormone receptor-positive breast cancer: similar outcome as triple negative breast cancer. BMC Cancer 15:138CrossRefPubMedPubMedCentral
Zurück zum Zitat Bogina G, Lunardi G, Coati F, Zamboni G, Gori S, Bortesi L, Marconi M, Cassabndrini PA, Turazza M, Cortesi L, DeMatteis E, Ficarra G, Ibrahim T, Serra P, Medri L, Giraudi S, Lambertini M, Carli F, Foglietta J, Sidoni A, Nunzi M, Ficorella C, Diadema MR, Del Mastro L (2015) Progesterone receptor status and clinical outcome in breast cancer patients with estrogen receptor-positive locoregional recurrence. Tumori 101(4):398–403CrossRefPubMed Bogina G, Lunardi G, Coati F, Zamboni G, Gori S, Bortesi L, Marconi M, Cassabndrini PA, Turazza M, Cortesi L, DeMatteis E, Ficarra G, Ibrahim T, Serra P, Medri L, Giraudi S, Lambertini M, Carli F, Foglietta J, Sidoni A, Nunzi M, Ficorella C, Diadema MR, Del Mastro L (2015) Progesterone receptor status and clinical outcome in breast cancer patients with estrogen receptor-positive locoregional recurrence. Tumori 101(4):398–403CrossRefPubMed
Zurück zum Zitat Caldarella A, Crocetti E, Bianchi S, Vezzosi V, Urso C, Biancalani M, Zappa M (2011) Female breast cancer status according to ER, PR and HER2 expression: a population based analysis. Pathol Oncol Res 17:753–758CrossRefPubMed Caldarella A, Crocetti E, Bianchi S, Vezzosi V, Urso C, Biancalani M, Zappa M (2011) Female breast cancer status according to ER, PR and HER2 expression: a population based analysis. Pathol Oncol Res 17:753–758CrossRefPubMed
Zurück zum Zitat Cserni G, Francz M, Kálmán E, Kelemen G, Komjáthy DC, Kovács I, Kulka J, Sarkadi L, Udvarhelyi N, Vass L, Vörös A (2011) Estrogen receptor negative and progesterone receptor positive breast carcinomas—How frequent are they? Pathol Oncol Res 17:663–668CrossRefPubMed Cserni G, Francz M, Kálmán E, Kelemen G, Komjáthy DC, Kovács I, Kulka J, Sarkadi L, Udvarhelyi N, Vass L, Vörös A (2011) Estrogen receptor negative and progesterone receptor positive breast carcinomas—How frequent are they? Pathol Oncol Res 17:663–668CrossRefPubMed
Zurück zum Zitat Goldhirsch A, Wood WC, Coates AS (2011) Strategies for subtypes—dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol 22:1736–1747 (The St. Gallen International Expert Consensus 2011) CrossRefPubMedPubMedCentral Goldhirsch A, Wood WC, Coates AS (2011) Strategies for subtypes—dealing with the diversity of breast cancer: highlights of the St. Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2011. Ann Oncol 22:1736–1747 (The St. Gallen International Expert Consensus 2011) CrossRefPubMedPubMedCentral
Zurück zum Zitat Hefti MM, Hu R, Knoblauhc NW, Collins LC, Haibe-Kains B, Tamimi RM, Beck AH (2013) Estrogen receptor negative/progesterone receptor positive breast cancer is not a reproducible subtype. Breast Cancer Res 15:R68CrossRefPubMedPubMedCentral Hefti MM, Hu R, Knoblauhc NW, Collins LC, Haibe-Kains B, Tamimi RM, Beck AH (2013) Estrogen receptor negative/progesterone receptor positive breast cancer is not a reproducible subtype. Breast Cancer Res 15:R68CrossRefPubMedPubMedCentral
Zurück zum Zitat Itoh M, Iwamoto T, Matsuoka J, Nogami T, Motoki T, Shien T, Taira N, Niikura N, Hayashi N, Ohtani S, Higaki K, Fujiwara T, Doihara H, Symmans WF, Pusztai L (2014) Estrogen receptor (ER) mRNA expression and molecular subtype distribution in ER-negative/progesterone receptor-positive breast cancers. Breast Cancer Res Treat 143:403–409CrossRefPubMed Itoh M, Iwamoto T, Matsuoka J, Nogami T, Motoki T, Shien T, Taira N, Niikura N, Hayashi N, Ohtani S, Higaki K, Fujiwara T, Doihara H, Symmans WF, Pusztai L (2014) Estrogen receptor (ER) mRNA expression and molecular subtype distribution in ER-negative/progesterone receptor-positive breast cancers. Breast Cancer Res Treat 143:403–409CrossRefPubMed
Zurück zum Zitat Kos Z, Dabbs DJ (2016) Biomarker assessment and molecular testing for prognostication in breast cancer. Histopathology 68:70–85CrossRefPubMed Kos Z, Dabbs DJ (2016) Biomarker assessment and molecular testing for prognostication in breast cancer. Histopathology 68:70–85CrossRefPubMed
Zurück zum Zitat Liu S, Chia SK, Mehl E, Leung S, Rajput A, Chemag MCU, Nielsen TO (2010) Progesterone receptor is a significant factor associated with clinical outcomes and effect of adjuvant tamoxifen therapy in breast cancer patients. Breast Cancer Res Treat 119:53–61CrossRefPubMed Liu S, Chia SK, Mehl E, Leung S, Rajput A, Chemag MCU, Nielsen TO (2010) Progesterone receptor is a significant factor associated with clinical outcomes and effect of adjuvant tamoxifen therapy in breast cancer patients. Breast Cancer Res Treat 119:53–61CrossRefPubMed
Zurück zum Zitat Nishimukai A, Yagi A, Miyagawa Y, Enomoto Y, Mrase K, Imamura M, Takatsuka Y, Sakita I, Hatada T, Miyoshi Y (2015) High Ki67 expression and low progesterone receptor expression could independently lead to a worse prognosis fro postmenopausal patients with estrogen receptor-positive and HER2-negative breast cancer. Clin Breast Cancer 15(3):204–211CrossRefPubMed Nishimukai A, Yagi A, Miyagawa Y, Enomoto Y, Mrase K, Imamura M, Takatsuka Y, Sakita I, Hatada T, Miyoshi Y (2015) High Ki67 expression and low progesterone receptor expression could independently lead to a worse prognosis fro postmenopausal patients with estrogen receptor-positive and HER2-negative breast cancer. Clin Breast Cancer 15(3):204–211CrossRefPubMed
Zurück zum Zitat Park S, Park BW, Kim TH, Jeon CW, Kang HS, Choi JE, Hwang KT, Kim IC (2013) Lack of either estrogen or progesterone expression is associated with poor survival outcome among luminal A breast cancer subtype. Ann Surg Oncol 20(5):1505–1513CrossRefPubMed Park S, Park BW, Kim TH, Jeon CW, Kang HS, Choi JE, Hwang KT, Kim IC (2013) Lack of either estrogen or progesterone expression is associated with poor survival outcome among luminal A breast cancer subtype. Ann Surg Oncol 20(5):1505–1513CrossRefPubMed
Zurück zum Zitat Prat A, Cheang MCU, Parker JS, Carrasco E, Caballero R, Tyldesley S, Gelmon K, Bernard PS, Nielsen TO, Perou CM (2013) Prognostic significance of progesterone receptor-positive tumor cells within immunohistochemically defined luminal a breast cancer. JCO 31:203–209CrossRef Prat A, Cheang MCU, Parker JS, Carrasco E, Caballero R, Tyldesley S, Gelmon K, Bernard PS, Nielsen TO, Perou CM (2013) Prognostic significance of progesterone receptor-positive tumor cells within immunohistochemically defined luminal a breast cancer. JCO 31:203–209CrossRef
Zurück zum Zitat Purdie CA, Quinlan P, Jordan LB, Ashfield A, Dewar JA, Thompson AM (2014) Progesterone receptor expression is an independent prognostic variable in early breast cancer: a population based study. BJC 110:565–572CrossRefPubMed Purdie CA, Quinlan P, Jordan LB, Ashfield A, Dewar JA, Thompson AM (2014) Progesterone receptor expression is an independent prognostic variable in early breast cancer: a population based study. BJC 110:565–572CrossRefPubMed
Zurück zum Zitat Rakha EA, El-Sayed ME, Green AR, Paish EC, Powe GD, Gee J, Nicholson RJ, Lee HSA, Robertson JFR, Ellis IO (2007) Biologic and clinical characteristics of breast cancer with single hormone receptor-positive phenotype. J Clin Oncol 25:4772–4778CrossRefPubMed Rakha EA, El-Sayed ME, Green AR, Paish EC, Powe GD, Gee J, Nicholson RJ, Lee HSA, Robertson JFR, Ellis IO (2007) Biologic and clinical characteristics of breast cancer with single hormone receptor-positive phenotype. J Clin Oncol 25:4772–4778CrossRefPubMed
Zurück zum Zitat Schroth W, Winter S, Buttner F, Goletz S, Faist S, Brinkmann F, Saldores P, Heidemann E, Ott G, Gerteis A, Alscher MD, Dippon J, Schwab M, Brauch H, Fritz P (2016) Clinical outcome and global gene expression data support the existence of the estrogen receptor-negative/progesterone receptor-positive invasive breast cancer phenotype. Breast Cancer Res Treat 155(1):85–97CrossRefPubMed Schroth W, Winter S, Buttner F, Goletz S, Faist S, Brinkmann F, Saldores P, Heidemann E, Ott G, Gerteis A, Alscher MD, Dippon J, Schwab M, Brauch H, Fritz P (2016) Clinical outcome and global gene expression data support the existence of the estrogen receptor-negative/progesterone receptor-positive invasive breast cancer phenotype. Breast Cancer Res Treat 155(1):85–97CrossRefPubMed
Zurück zum Zitat Shen T, Brandwein-Gensler M, Hameed O, Siegal GP, Wei S (2015) Characterization of estrogen receptor-negative/progesterone receptor-positive breast cancer. Human Pathol 46:1776–1784CrossRef Shen T, Brandwein-Gensler M, Hameed O, Siegal GP, Wei S (2015) Characterization of estrogen receptor-negative/progesterone receptor-positive breast cancer. Human Pathol 46:1776–1784CrossRef
Zurück zum Zitat Sun JY, Wu SG, Li FY, Lin HX, He ZY (2016) Progesterone receptor loss identifies hormone receptor-positive and HER2-negative breast cancer subgroups at higher risk of relapse: a retrospective cohort study. OncoTargets Ther 9:1707–1713 Sun JY, Wu SG, Li FY, Lin HX, He ZY (2016) Progesterone receptor loss identifies hormone receptor-positive and HER2-negative breast cancer subgroups at higher risk of relapse: a retrospective cohort study. OncoTargets Ther 9:1707–1713
Metadaten
Titel
Prognostic role of progesterone receptor expression in a population-based analysis
verfasst von
Adele Caldarella
Alessandro Barchielli
Publikationsdatum
09.09.2017
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Cancer Research and Clinical Oncology / Ausgabe 12/2017
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-017-2514-3

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