Quantitative expression of estrogen receptor on relapse biopsy for ER-positive breast cancer: Prognostic impact

Maria Vittoria Dieci, Federico Piacentini, Massimo Dominici, Claudia Omarini, Aicha Goubar, Guido Ficarra, Pierfranco Conte, Valentina Guarneri

Research output: Contribution to journalArticlepeer-review


Background: The aim of this study was to evaluate the prognostic impact of quantitative estrogen receptor (ER) expression at relapse for ER-positive breast cancer with ER-positive recurrence. Patients and Methods: A total of 81 patients with ER-positive primary breast cancer and ER-positive paired recurrence were included. ER expression was evaluated as the percentage of tumor cells staining for ER under immunohistochemistry. Samples were defined as ER-high (ER >50%) or ER-low (ER ≥10% and ≤50%). Results: Quantitative ER expression on relapse biopsy was an independent prognostic factor for overall survival in multivariate analysis, both as a continuous (hazard ratio=0.8; 95% confidence interval=0.7-0.92, p=0.001) and as a categorical (ER-high vs. ER-low; hazard ratio=0.26; 95% confidence interval=0.11-0.59, p=0.001) variable. Patients whose status changed from ER-high (primary BC) to ER-low (relapse) had the poorest outcome, with a 10-year overall survival rate of 14%. Conclusion: Even in the case of maintenance of ER-positivity on primary and relapse of breast cancer, recurrence biopsy provides prognostic information.

Original languageEnglish
Pages (from-to)3657-3662
Number of pages6
JournalAnticancer Research
Issue number7
Publication statusPublished - Jul 1 2014


  • Estrogen receptor
  • Metastatic breast cancer
  • Receptor discordance

ASJC Scopus subject areas

  • Cancer Research
  • Oncology


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