Abstract Background: PGRMC1 (progesterone receptor membrane component 1) is a highly conserved heme binding protein which is overexpressed especially in hormone receptor positive breast cancer and plays an important role in breast cancer carcinogenesis. Nevertheless, little is known about the mechanisms by which PGRMC1 drives tumor progression. Based on our previous studies on the involvement of PGRMC1 in cholesterol metabolism we describe a potential mechanism by which PGRMC1 can increase lipid metabolism and alter EGFR signaling. Methods: To obtain PGRMC1 overexpressing cell lines, MCF7, T47D and MDA cells were stably transfected with expression plasmid pcDNA3.1. containing HA-tagged PGRMC1. As a control, cells transfected with the empty plasmid were used.To investigate the role of PGRMC1 in breast cancer progression, expression of genes involved in lipid metabolism were quantified by qPCR. Subsequent lipid and cholesterol levels as well as lipid raft expression were measured by flow cytometry in various breast cancer cell lines overexpressing PGRMC1 compared to empty vector control. Since many studies show that EGFR is enriched in lipid rafts, we further investigated alteration of EGFR/HER2 signaling through PGRMC1 overexpression via western blot and immunofluorescence analyses. The impact of lipid inhibition on tumor progression was analyzed by viability assays. Results: PGRMC1 overexpression resulted in higher levels of mRNA coding for proteins responsible for lipid homeostasis (SREPF1, SREBF2), lipid uptake (LDLR) and lipid synthesis (FASN, HMGCS, SCD, ACAT) leading to higher levels of neutral lipids, estradiol and cholesterol. Furthermore, PGRMC1 overexpressing hormone receptor positive cells show increased lipid raft formation with higher expression of EGFR/HER2 and altered EGFR/HER2 signaling. PGRMC1 overexpressing cells are more sensitive to a simvastatin treatment, which indicates a higher dependence of PGRMC1 overexpressing cells on cholesterol synthesis. Conclusion: Cholesterol and lipid metabolism play an important role in breast carcinogenesis. Our recent studies underline the effects of PGRMC1 on increasing lipid synthesis and uptake thereby altering oncogenic signaling. PGRMC1 overexpressing breast cancer cells could be particularly suitable for a statin treatment. Citation Format: Hannah Asperger, Marina Ludescher, Nadia Stamm, Jan-Philipp Cieslik, Ute Hofmann, Ulrich Zanger, Zaklina Kovacevic, Des Richardson, Eugen Ruckhäberle, Tanja Fehm, Dieter Niederacher, Hans Neubauer. Progesterone receptor membrane component 1 - A novel key regulator in lipid homeostasis drives oncogenic signaling resulting in breast cancer progression [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-04-02.