Clinical factors related to the presence of estrogen receptors in breast cancer: a prognostic stratification analysis.

The techniques used for determination of hormone receptors have provided a biochemical basis to the concept of hormone-dependence in breast cancer. By medical experience clinical factors were established for determination of hormonal treatment in breast tumors. The criteria used need now to be re-evaluated in terms of hormone receptor contents. We analysed a group of 155 patients with histologically confirmed breast carcinoma in which estradiol receptor determination was performed. Of these tumors 54% had more than 10 fmol of estradiol per mg protein. Menopause, advanced age, late first childbirth, obesity, early menopause and nuliparity were associated, in that order, with the presence of estrogen receptors in breast tumors. Prognostic stratification analysis brought out polar groups of estrogen receptor contents. Young, premenopausal women with children had only 16% estrogen receptor-positive tumors. Postmenopausal women, either without children or with late first childbirth had as much as 81% of estrogen receptor containing tumors. Clinical variables related to the presence of estrogen receptor positive tumors in the breast cancer population were coincident to risk factors for breast cancer in the healthy population. Possible implications of this coincidences are discussed.