ArticleJournal of Cancer2014
A Majority of Low (1-10%) ER Positive Breast Cancers Behave Like Hormone Receptor Negative Tumors.
Article in Journal of Cancer, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 3 of them syntheses that pooled it.
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Who cites it
53 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Treatment consequence and adverse events of cyclin-dependent kinase 4/6 inhibitors on patients with hormone receptor-positive, HER2-negative metastatic breast cancer: a systematic review and meta-analysis.Annals of medicine · 2025Pooled it
- The prognostic and predictive impact of low estrogen receptor expression in early breast cancer: a systematic review and meta-analysis.ESMO open · 2021Pooled it
- Higher ER load is not associated with better outcome in stage 1-3 breast cancer: a descriptive overview of quantitative HR analysis in operable breast cancer.Breast cancer research and treatment · 2019Pooled it
- Adjuvant Capecitabine for Early Breast Cancer: 15-Year Overall Survival Results From a Randomized Trial.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2022Trial
- Adjuvant Capecitabine in Combination With Docetaxel, Epirubicin, and Cyclophosphamide for Early Breast Cancer: The Randomized Clinical FinXX Trial.JAMA oncology · 2017Trial
- Minimal Residual Disease in Breast Cancer: Tumour Microenvironment Interactions, Detection Methods and Therapeutic Approaches.International journal of molecular sciences · 2025Review
- Reporting Hormone Receptor Expression in Breast Carcinomas: Which Method has the Highest Prognostic Power and What Should be the Optimal Cut-off Value?International journal of surgical pathology · 2025Article
- Impact of low hormone receptor expression on neoadjuvant chemotherapy response and patterns of care in non-metastatic HER2-negative breast cancer: a US National Cancer Database analysis.Therapeutic advances in medical oncology · 2025Article
- Clinical outcomes of early-stage triple-negative breast cancer after neoadjuvant chemotherapy according to HER2-low status☆.ESMO open · 2024Article
- Real-world data of HER2-negative early breast cancer patients treated with anthracycline and/or taxane regimens in Japan.Breast cancer (Tokyo, Japan) · 2024Observational
- Article
- Defining the Biology of Estrogen Receptor-Low-Positive Breast Cancer.Annals of surgical oncology · 2024Article
- Naringenin as potent anticancer phytocompound in breast carcinoma: from mechanistic approach to nanoformulations based therapeutics.Frontiers in pharmacology · 2024Review
- Comparison of neoadjuvant chemotherapy response and prognosis between HR-low/HER2-negative BC and TNBC: an exploratory real-world multicentre cohort study.Frontiers in endocrinology · 2024Article
- Estrogen-Receptor-Low-Positive Breast Cancer: Pathological and Clinical Perspectives.Current oncology (Toronto, Ont.) · 2023Review
- Impact of estrogen receptor expression level on response to neoadjuvant chemotherapy and prognosis in HER2-negative breast cancers.BMC cancer · 2023Article
- Article
- Concordance of immunohistochemistry for predictive and prognostic factors in breast cancer between biopsy and surgical excision: a single-centre experience and review of the literature.Breast cancer research and treatment · 2023Review
- Cell State Transitions and Phenotypic Heterogeneity in Luminal Breast Cancer Implicating MicroRNAs as Potential Regulators.International journal of molecular sciences · 2023Article
- Evaluating the expression of heat shock protein 27 and topoisomerase II α in a retrospective cohort of patients diagnosed with locally advanced breast cancer and treated with neoadjuvant anthracycline-based chemotherapies.Frontiers in oncology · 2023Article
Corrections and comments
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Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe 2010 guidelines by ASCO-CAP have mandated that breast cancer specimens with ≥1% positively staining cells by immunohistochemistry should be considered Estrogen Receptor (ER) positive. This has led to a subclass of low-ER positive (1-10%) breast cancers. We have examined the biology and clinical behavior of these low ER staining tumors.
methodsWe have developed a probabilistic score of the "ER-positivity" by quantitative estimation of ER related gene transcripts from FFPE specimens. Immunohistochemistry for ER was done on 240 surgically excised tumors of primary breast cancer. Relative transcript abundance of 3 house-keeping genes and 6 ER related genes were determined by q-RT PCR. A logistic regression model using 3 ER associated genes provided the best probability function, and a cut-off value was derived by ROC analysis. 144 high ER (>10%), 75 ER negative and 21 low-ER (1-10%) tumors were evaluated using the probability score and the disease specific survival was compared.
resultsHalf of the low-ER positive tumors were assigned to the ER negative group based on the probability score; in contrast 95% of ER negative and 92% of the high ER positive tumors were assigned to the appropriate ER group (p<0.0001). The survival of the low-ER group was intermediate between that of the high ER positive and ER negative groups (p<0.05).
conclusionOur results suggest that the newly lowered ASCO-CAP criteria for ER positivity, leads to the false categorization of biologically ER negative tumors as ER positive ones. This may have particular relevance to India, where we have a much higher proportion of ER negative tumors in general.
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