Balduzzi Alessandra, Bagnardi Vincenzo, Rotmensz Nicole, Dellapasqua Silvia, Montagna Emilia, Cardillo Anna, Viale Giuseppe, Veronesi Paolo, Intra Mattia, Luini Alberto, Pruneri Giancarlo, Mastropasqua Giuseppe, Goldhirsch Aron, Colleoni Marco
Division of Medical Senology, European Institute of Oncology, Milan, Italy.
Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy; Department of Statistics and Quantitative Methods, Unit of Biostatistics, Epidemiology and Public Health, University of Milan-Bicocca, Milan, Italy.
Clin Breast Cancer. 2014 Aug;14(4):258-64. doi: 10.1016/j.clbc.2013.10.019. Epub 2013 Oct 26.
The prognostic value of low estrogen and progesterone receptors expression (ER/PgR 1%-10%) in early breast cancer patients is still unclear.
We retrospectively analyzed 1424 consecutive patients with HER2/neu-negative and low endocrine receptors expression early breast cancer, submitted to surgery at the European Institute of Oncology between January 1995 and December 2009. Patients were classified according to the percentage of ER/PgR expression using immunohistochemistry. Group 1 with ER/PgR < 1%, and group 2 with ER/PgR 1% to 10%.
Group 1 (ER/PgR < 1%) included 1300 patients, and group 2 (ER/PgR 1%-10%) 124 patients. Median follow-up time was 74 months (range, 3-192 months). The 5-year disease-free survival (DFS) rate was 74% (95% confidence interval [CI], 72%-77%) for group 1, and 79% (95% CI, 70%-86%) for group 2 (P = .16). The 5-year overall survival (OS) rate was 86% (95% CI, 84%-88%) in group 1 and 90% (95% CI, 83%-95%) in group 2 (P = .13). In patients without lymph node involvement, the 5-year OS rate was 92% (95% CI, 89.5%-93.6%) for group 1 and 98% (95% CI, 90.2%-99.8%) for group 2 (P = .061). One hundred ten patients received endocrine therapy with no significant effect on DFS (P = .36) and OS (P = .30).
The ER/PgR 1%-10% group had a slight, but not statistically significant, better prognosis than the ER/PgR <1% group. Further studies are needed to identify the appropriate clinical approach in this subset of patients with low ER/PgR expression (ER/PgR 1%-10%), HER2-negative early breast cancer.
早期乳腺癌患者中雌激素和孕激素受体低表达（ER/PgR 1%-10%）的预后价值仍不明确。
我们回顾性分析了1995年1月至2009年12月期间在欧洲肿瘤研究所接受手术的1424例连续的HER2/neu阴性且内分泌受体低表达的早期乳腺癌患者。采用免疫组织化学方法根据ER/PgR表达百分比对患者进行分类。第1组ER/PgR<1%，第2组ER/PgR 1%至10%。
第1组（ER/PgR<1%）包括1300例患者，第2组（ER/PgR 1%-10%）包括124例患者。中位随访时间为74个月（范围3-192个月）。第1组的5年无病生存率（DFS）为74%（95%置信区间[CI]，72%-77%），第2组为79%（95%CI，70%-86%）（P = 0.16）。第1组的5年总生存率（OS）为86%（95%CI，84%-88%），第2组为90%（95%CI，83%-95%）（P = 0.13）。在无淋巴结受累的患者中，第1组的5年OS率为92%（95%CI，89.5%-93.6%），第2组为98%（95%CI，90.2%-99.8%）（P = 0.061）。110例患者接受了内分泌治疗，对DFS（P = 0.36）和OS（P = 0.30）无显著影响。
ER/PgR 1%-10%组的预后略好于ER/PgR<1%组，但差异无统计学意义。需要进一步研究以确定对于这一ER/PgR低表达（ER/PgR 1%-10%）、HER2阴性的早期乳腺癌患者亚组的合适临床治疗方法。
