SynthesisESMO open2021
The prognostic and predictive impact of low estrogen receptor expression in early breast cancer: a systematic review and meta-analysis.
Synthesis in ESMO open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07521397 (Pooled Analysis of Individual Patient Data of Patients With Early-stage Breast Cancer Treated With Adjuvant Dose-dense Sequential Chemotherapy), which is not on this map. Cited by 43 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pooled Analysis of Individual Patient Data of Patients With Early-stage Breast Cancer Treated With Adjuvant Dose-dense Sequential Chemotherapy (Ddsc): a Hellenic Cooperative Oncology Group (HeCOG) Study
Who cites it
43 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- Association between endocrine therapy and survival outcomes in estrogen receptor-low breast cancer: a systematic review and meta-analysis.The oncologist · 2026Pooled it
- PROMENADE: pembrolizumab for early ER-low/HER2-negative breast cancer, real-world French cohort.ESMO open · 2025Trial
- Endocrine Therapy Omission in Estrogen Receptor-Low (1-10%) Early Stage Breast Cancer: An Updated Analysis of the NCDB Database.Annals of surgical oncology · 2026Article
- Prognostic value of hormone receptor expression in patients with HR+/HER2- advanced BC treated with first-line ET+CDK4/6i: results from the multicentre observational, real-world PALMARES-2 study.EClinicalMedicine · 2026Article
- Effect of dose-dense adjuvant chemotherapy in patients with node-positive early breast cancer according to estrogen receptor levels: an exploratory analysis of the GIM2 trial.Breast (Edinburgh, Scotland) · 2026Article
- Evolution of ER-cut-off definition in clinical trials for triple negative breast cancer: trends and patterns over 15 years.Breast (Edinburgh, Scotland) · 2026Review
- Characteristics and outcomes of patients with HER2-negative metastatic breast cancers with low expression of estrogen and progesterone receptors in the multicenter ESME cohort.Breast (Edinburgh, Scotland) · 2026Article
- Estrogen receptor status low status in breast cancer: clinicopathological factors and prognostic value.Przeglad menopauzalny = Menopause review · 2026Article
- Germline BRCA1/2 Mutation Prevalence in Unselected ER-Low/HER2-Negative Breast Cancer.Annals of surgical oncology · 2026Article
- Estrogen Receptor-Low Positive (ER-Low) Breast Cancer: A Unique Clinical and Pathological Entity.Current oncology (Toronto, Ont.) · 2026Review
- Defining prognostic subgroups and treatment outcomes in estrogen receptor low-positive de novo metastatic breast cancer.Breast cancer research and treatment · 2026Observational
- Impact of estrogen receptor expression levels on chemo-responsiveness and prognosis of breast cancer patients treated with neoadjuvant chemotherapy.NPJ breast cancer · 2026Article
- Prognosis and endocrine therapy efficacy in early breast cancer with estrogen receptor low expression.Breast cancer research and treatment · 2026Article
- Adjuvant endocrine therapy in estrogen-low breast cancer in the era of CDKI: are we at another uncertain crossroads?Frontiers in oncology · 2026Review
- Reconsidering the definition of triple-negative breast cancer in the immune checkpoint inhibitor era: an optimal cut-off value for hormone receptor percentage of HER2-negative invasive breast cancer.British journal of cancer · 2026Review
- Distribution and molecular drivers of the 21-gene recurrence score in early breast cancer with low, intermediate, and high estrogen receptor expression.Frontiers in immunology · 2026Article
- Survival analysis of adjuvant endocrine therapy in HER2 positive early breast cancer patients with low ER positivity.Breast cancer research : BCR · 2025Article
- The Management of ER-Low, HER2-Negative Breast Cancer in the United Kingdom: A Survey of Current Clinical Practice.Oncology and therapy · 2025Article
- Emerging Breast Cancer Subpopulations: Functional Heterogeneity Beyond the Classical Subtypes.International journal of molecular sciences · 2025Review
- Real-world survival outcomes of neoadjuvant versus adjuvant chemotherapy in operable triple-negative breast cancer: a propensity score matched registry-based study.Acta oncologica (Stockholm, Sweden) · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTraditionally, estrogen receptor (ER)-positive breast cancer has been defined as tumors with ≥1% positive for ER. The updated American Society of Clinical Oncology/College of American Pathologists (ASCO/CAP) guidelines recommend that tumors with ER expression of 1%-10% should be classified as ER-low-positive, recognizing the limited clinical evidence on the prognostic and predictive role of low ER expression. We aimed to investigate the predictive role of ER-low expression to neoadjuvant chemotherapy (NeoCT) and the prognostic significance of ER-low expressing breast tumors compared with ER-positive or ER-negative breast tumors.
methodsA meta-analysis was conducted using the Meta-analyses Of Observational Studies in Epidemiology (MOOSE) guidelines and eligible articles were identified on PubMed and ISI Web of Science databases. The primary outcome was pathologic complete response and secondary outcomes were disease-free survival (DFS) and overall survival (OS). Twelve retrospective cohort studies were included in the meta-analysis. NeoCT resulted in higher pathologic complete response among patients with ER-low expression compared with ER-positive and comparable to ER-negative. Patients with ER-low breast cancer had a statistically significant worse DFS and OS compared with patients with ER-positive breast cancer, whereas no difference in DFS or OS was observed between ER-low and ER-negative subgroups. DISCUSSION: The current evidence suggests that ER-low breast cancer has a more similar outcome to ER-negative than to ER-positive breast cancer in terms of DFS and OS. ER-low expression seems also to have a predictive role regarding NeoCT. Considering the certainty of current evidence categorized as low to moderate, our results urge the need for well-designed prospective studies investigating the molecular background and the most appropriate treatment strategy for ER-low expressing breast cancer.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.