Do Clinical Features and Survival of Single Hormone Receptor Positive Breast Cancers Differ from Double Hormone Receptor Positive Breast Cancers?

Abstract

The significance of the single hormone receptor positive phenotype of breast cancer is still poorly understood.The use of hormone therapy has been found to be less effective for this type, which has a survival outcome midwaybetween double positive and double negative phenotypes. The aim of this study was to investigate differencesin patient and tumor characteristics and survival between double-receptor positive (ER+PR+), double receptornegative (ER-PR-) and single receptor positive (ER+PR- and ER-PR+) breast cancer in an Asian setting. Atotal of 1,992 patients with newly diagnosed stage I to IV breast cancer between 2003 and 2008, and whereinformation on ER and PR were available, were included in this study. The majority of patients had ER+PR+tumors (n=903: 45.3%), followed by 741 (37.2%) ER-PR-, 247 (12.4%) ER+PR-, and 101 (5.1%) ER-PR+ tumors.Using multivariate analysis, ER+PR- tumors were 2.4 times more likely to be grade 3 compared to ER+PR+tumors. ER+PR- and ER-PR+ tumors were 82% and 86% respectively less likely to be grade 3 compared withER-PR- tumors. ER-PR+ tumours were associated with younger age. There were no survival differences betweenpatients with ER+PR+ and ER-PR+ tumors. However, ER+PR- tumors have poorer survival compared withER+PR+ tumours. ER-PR- tumours had the worst survival. Adjuvant hormonal therapy with tamoxifen wasfound to have identical survival advantage in patients with ER+PR+ and ER-PR+ tumors whereas impact wasslightly lower in patients with ER+PR- tumors. In conclusion, we found ER+PR- tumors to be more aggressiveand have poorer survival when compared to ER+PR+ tumors, while patients with ER-PR+ tumours were younger,but had a similar survival to their counterparts with ER+PR+ tumours.