Abstract

Simple SummaryBreast cancer is the most commonly diagnosed cancer and the leading cause of cancer death of women worldwide. Several cut-points for estrogen receptor (ER) and progesterone receptor (PgR) have been proposed as predictive effects of hormone therapy; while the cut-off values were inconsistent. The aim of our retrospective study was to propose better prognostic cut-off levels for ER and PgR, and their effects on breast cancer-specific survival (BCSS) and disease-free survival (DFS) over 5 and 10 years were evaluated in 1807 eligible patients. Subgroups were generated based on ER and PgR expression percentage and scoring from the Allred scoring system (Allred scores). After comparing the hazard ratios (event rates in each group to reference group) of BCSS and DFS using multivariate analyses, our results suggested that patients with PgR expression ≤50% or Allred score ≤5 revealed a poor prognosis and should be paid more attention during follow-up.Background: To realize the association between stratified expression levels of ER and PgR and long-term prognosis of breast cancer patients who received adjuvant hormone therapy, this study aimed to propose better prognostic cut-off levels for estrogen receptor (ER) and progesterone receptor (PgR). Methods: Patients who received adjuvant hormone therapy after surgical intervention were selected. The ER and PgR status and their effects on breast cancer-specific survival (BCSS) and disease-free survival (DFS) over 5 and 10 years were evaluated. Next, subgroups were generated based on ER and PgR expression percentage and Allred scores. Survival curves were constructed using the Kaplan–Meier method. Results: ER and PgR expression were significantly associated with better prognosis in 5 years, whereas only PgR expression was significantly associated during the 10-year follow-up. The optimal cut-off values for better 5-year BCSS were ER > 50%; ER Allred score > 7; PgR ≥ 1%; or PgR Allred score ≥ 3; the corresponding values for DFS were ER > 40%; ER Allred score > 6; PgR > 10%; or PgR Allred score ≥ 3. In the long-term follow-up, PgR of > 50% or Allred score of > 5 carriers revealed a better prognosis of both BCSS and DFS. Conclusion: Patients with a PgR expression > 50% or an Allred score > 5 exhibited better 10-year BCSS and DFS.

Highlights

  • Among females, breast cancer (BC) is the most commonly diagnosed cancer and the leading cause of cancer death worldwide [1]

  • During the follow-up period, 122 patients died from causes attributable to BC and 138 patients exhibited local or distant recurrence

  • Retrospectively evaluated theofassociation between prognostic according to their percentage or expression level was signifirisks of breast cancer-specific survival (BCSS) and disease-free survival (DFS) events and to the stratification of estrogen receptor (ER) and progesterone receptor (PgR) expression levels cantly associated with a better prognosis in both

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Summary

Introduction

Breast cancer (BC) is the most commonly diagnosed cancer and the leading cause of cancer death worldwide [1]. BC can be classified into luminal, human epidermal growth factor receptor-2 (HER2), or triple-negative subtypes after immunohistochemical (IHC) analysis of the estrogen receptor (ER), progesterone receptor (PgR), HER2, and Ki-67. Patients who present with the luminal subtype are subjected to hormone therapy [2]. Those with HER2 subtype exhibit relatively poorer outcomes, but they can be treated with anti-HER2 targeted therapy; likewise, triple-negative subtypes BCs demonstrate a poor prognosis and can optimally be treated via chemotherapy, immunotherapy, or antibodydrug conjugate for advanced staged patients, or targeted therapy with poly(adenosine diphosphate-ribose) polymerase inhibitors in advanced patients with germline BRCA1 or BRCA2 mutation [2,3,4,5]. To realize the association between stratified expression levels of ER and PgR and long-term prognosis of breast cancer patients who received adjuvant hormone therapy, this study aimed to propose better prognostic cut-off levels for estrogen receptor (ER) and progesterone receptor (PgR). Results: ER and PgR expression were significantly associated with better prognosis in 5 years, whereas only PgR expression was significantly associated during the

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