Relation of steroid hormone receptors to axillary lymph node metastasis in breast carcinoma

Abstract

In 337 patients with primary cancer of the breast, the oestrogen and progesterone receptor concentration was correlated to the metastasis of axillary lymph nodes taking into account the age of the patients and the size of the primary tumour. The frequency of axillary lymph node involvement increases significantly with size, although not quite steadily but rather stepwise within the T classification. Whereas the tumour diameter influences the receptor status only slightly, the age of the patients plays a major rôle in the oestrogen receptor concentration. In the age group up to 50 years the oestrogen receptor concentration is significantly lower than in the age group over 50 years. There is no comparable influence of age on progesterone receptor concentration. With all 337 breast cancers, no difference in axillary lymph node metastasis is found either between oestrogen receptor positive and oestrogen receptor negative cancers, or between progesterone receptor positive and progesterone receptor negative cancers. In the age group up to 50 years, if looked upon separately, the oestrogen receptor positive cancers do show significantly more often an axillary lymph node involvement, than do oestrogen receptor negative cancers. As this difference exists in the age group up to 50 years only, it is assumed that endogenous oestradiol favours the axillary spread in oestrogen receptor positive cancers. With oestrogen receptor negative cancers the axillary lymph node involvement increases from the younger to the older age group, explaining why in unselected series the oestrogen receptor negative cancers show a more unfavourable course.