Abstract
Recurrence and survival rates were studied in 175 women with breast cancer who, until the development of recurrent disease, received no treatment other than a modified radical (Patey) mastectomy, and in whom the oestrogen (REc) and progesterone (RPc) receptor content of the primary tumour was measured. At the time of first relapse most patients received endocrine therapy. At a minimum follow-up of 58 months post menopausal patients who possessed REc had an increased relapse-free survival (RFS) (P = 0.02). When examined by node status patients with 1-3 axillary nodes containing tumour also had an improvement in RFS (P = 0.02). There was no benefit for node-negative or premenopausal patients. In 163 patients in whom RPc was measured, RFS was unaffected by the possession of this receptor regardless of the degree of node involvement or menopausal status. Patients with REc had a significantly longer survival following mastectomy than patients without it (P = 0.006). This was most marked in post-menopausal (P = 0.003) and node-positive (P = 0.03) patients. Survival following mastectomy was also increased in patients possessing RPc (P = 0.04) and again was most marked for post-menopausal patients (P = 0.01), although no difference could be identified within node subgroups. There were significant differences in the post-relapse survival of REc and RPc positive and negative patients (REc P = 0.03, RPc P = 0.001). Patients with both receptors survived approximately 37 months longer than their receptor-negative counterparts. This study failed to confirm that the measurement of REc and RPc can reliably predict early relapse in breast cancer. The greater overall survival of receptor-positive patients is mainly due to an increase in survival following relapse. This may reflect the response of receptor-positive tumours to endocrine therapy given for recurrent disease.
Highlights
At a minimum follow-up of 58 months post menopausal patients who possessed REc had an increased relapse-free survival (RFS) (P= 0.02)
Negative results from tumours where the cytosol protein was less than 0.7 mg ml-1 were excluded from the study
For the study of relapse free survival (RFS), overall survival and post-relapse survival (PRS), time based curves were computed by actuarial methods and compared by the log-rank test (Peto et al, 1977)
Summary
Oestrogen (REc) and progesterone (RPc) receptors were measured in samples of histologically proven primary tumours from women with breast cancer. Values greater than 5 fmol mg- 1 for REc and 15 fmol mg- 1 for RPc of cytosol protein were regarded as positive. Negative results from tumours where the cytosol protein was less than 0.7 mg ml-1 were excluded from the study. One hundred and seventy five women with operable disease (Tl-3 NO-1MO) were studied. Patients with bilateral tumours or distant metastases and those receiving adjuvant endocrine or cytotoxic therapy, were excluded from the study. For the study of relapse free survival (RFS), overall survival and post-relapse survival (PRS), time based curves were computed by actuarial methods and compared by the log-rank test (Peto et al, 1977). Comparison of the different numbers of patients in subgroups was done using the Chi-squared test for contingency tables
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