Evidence map›Paper›PMID 40684412›Full record

ArticleBreast cancer (Tokyo, Japan)2025

Breast tumors with intermediate ER expression differ biologically from ER-low tumors and exhibit a more favorable prognosis.

Yuko Ueki, Yoshiya Horimoto, Kazuharu Harada, Yumiko Ushiyama, Yumiko Ishizuka, Hiroko Onagi, Takuo Hayashi, Tsuyoshi Saito, Takahiko Kawate, Takashi Ishikawa and 2 more

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Article in Breast cancer (Tokyo, Japan), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

12 authors.

Yuko UekiDepartment of Breast Oncology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Yoshiya HorimotoDepartment of Breast Oncology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan. horimoto.yoshiya.4m@tokyo-med.ac.jp.ORCID http://orcid.org/0000-0001-8935-0768
Kazuharu HaradaDepartment of Health Data Science, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan.
Yumiko UshiyamaDepartment of Breast Oncology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Yumiko IshizukaDepartment of Breast Oncology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.ORCID http://orcid.org/0000-0002-1588-3067
Hiroko OnagiDepartment of Human Pathology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Takuo HayashiDepartment of Human Pathology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Tsuyoshi SaitoDepartment of Human Pathology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Takahiko KawateDepartment of Breast Surgery and Oncology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan.
Takashi IshikawaDepartment of Breast Surgery and Oncology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo, 160-8402, Japan.ORCID http://orcid.org/0000-0003-3450-4533
Junichiro WatanabeDepartment of Breast Oncology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.ORCID http://orcid.org/0000-0001-9226-895X
Goro KutomiDepartment of Breast Oncology, Faculty of Medicine, Juntendo University, 2-1-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEstrogen receptor (ER) expression in breast cancer exhibits a widely recognized bimodal distribution, with increasing focus on the biological and clinical characteristics of the low-expression group. However, tumors with intermediate ER expression have been relatively understudied. This study aimed to clarify the clinicopathological and prognostic features of ER-intermediate (ER-int) tumors by comparing them with ER-low tumors.

methodsTumors were classified into ER-low (1-10%), ER-int (11-70%), and ER-high (71-100%) groups based on immunohistochemistry. We retrospectively analyzed 261 breast cancer patients with ER-low or ER-int tumors who underwent curative surgery. Clinicopathological features and treatment outcomes were compared, and factors influencing distant recurrence-free survival (DRFS) and overall survival (OS) were evaluated using Cox proportional hazard models. For analysis of clinical outcomes, after excluding HER2-positive tumors, an additional cohort of 604 patients with ER-high and HER2-negative tumors was also compared.

resultsER-int tumors showed lower nuclear grade, higher progesterone receptor expression, and lower Ki67 labeling index compared with ER-low tumors. Pathological stage was independently associated with both DRFS and OS. In addition, ER status was also an independent factor for OS, with ER-int tumors showing significantly better OS than ER-low tumors (P = 0.014).

conclusionsOur findings, based on comparison with ER-low tumors, suggest that intermediate ER expression may represent a biologically and clinically heterogeneous subgroup within ER-positive breast cancers. Recognition of this heterogeneity could help refine classification and support more individualized treatment strategies.

Indexed as

Breast NeoplasmsReceptors, EstrogenAdultAgedAged, 80 and overBiomarkers, TumorErb-b2 Receptor Tyrosine KinasesFemaleHumansImmunohistochemistryMiddle AgedPrognosisReceptors, ProgesteroneRetrospective StudiesBiomarkers, TumorERBB2 protein, humanErb-b2 Receptor Tyrosine KinasesReceptors, EstrogenReceptors, ProgesteroneBreast neoplasmsChemotherapyEstrogen receptor alphaHormone-dependent neoplasmsImmunohistochemistryPrognostic factor

Identifiers

PMID40684412

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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.