Hormone Receptor Status

Also known as: Estrogen receptors; Progesterone receptors; ER and PR status

Formal name: Estrogen and Progesterone receptor status

At a Glance

Why Get Tested?

To determine whether a breast cancer tumor is positive for estrogen and/or progesterone receptors, which helps to guide treatment and determine prognosis

When to Get Tested?

When you have been diagnosed with breast cancer and your doctor wants to determine whether the tumor's growth is influenced by the hormones estrogen and/or progesterone

Sample Required?

A sample of breast cancer tissue obtained during a biopsy or a tumor removed surgically during a lumpectomy or mastectomy

Test Preparation Needed?

Your doctor may have you discontinue taking hormones for a time period before your sample is collected.

The Test Sample

What is being tested?

Estrogen receptors (ER) and progesterone receptors (PR) are specialized proteins found within certain cells throughout the body. These receptors bind to estrogen and progesterone, female hormones that circulate in the blood, and promote new cell growth and division.

Many breast cancer tumors have receptors for estrogen and/or progesterone, often in large numbers. These tumors are said to be hormone-dependent, and estrogen and/or progesterone feed their growth. Breast cancer tissue can be tested to see if it is positive for these receptors.

How is the sample collected for testing?

A sample of breast cancer tissue is obtained by doing a fine needle aspiration, needle biopsy, or surgical biopsy or when a tumor removed surgically during a lumpectomy or mastectomy is tested.

NOTE: If undergoing medical tests makes you or someone you care for anxious, embarrassed, or even difficult to manage, you might consider reading one or more of the following articles: Coping with Test Pain, Discomfort, and Anxiety, Tips on Blood Testing, Tips to Help Children through Their Medical Tests, and Tips to Help the Elderly through Their Medical Tests.

Another article, Follow That Sample, provides a glimpse at the collection and processing of a blood sample and throat culture.

Is any test preparation needed to ensure the quality of the sample?

Your doctor may have you discontinue taking hormones for a time period before your sample is collected.

The Test

How is it used?

Estrogen and progesterone hormone receptor status tests are typically performed on all invasive breast cancers. Hormone receptor status is used as a prognostic marker, and used to help guide the treatment of people with primary or recurrent breast cancer.

Those who have ER-positive and PR-positive tumors tend to have a better prognosis for disease-free survival and overall survival than those with ER-negative or PR-negative tumors. They are also much more likely to respond to endocrine therapy (anti-hormone treatments such as tamoxifen).

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When is it ordered?

Hormone receptor status testing is recommended as part of an initial workup of invasive breast cancer. It is not diagnostic but helps the doctor to determine treatment options and to understand more about the tumor's characteristics.

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What does the test result mean?

In general, if a person's cancer is ER-positive and PR-positive, the patient will have a better-than-average prognosis, and their cancer is likely to respond to endocrine therapy (anti-hormone treatments). The more receptors present and the more intense their reaction, the more likely the response. If a person's cancer is ER-negative but PR-positive, or ER-positive but PR-negative, then she may still benefit from endocrine therapy but may have a diminished response.

If the cancer is both ER-negative and PR-negative, then the person will probably not benefit from endocrine therapy.

An individual's response to endocrine therapy will depend on a variety of factors, but typical response rates include:

ER positive, PR positive: 75-80%
ER positive, PR negative: 40-50%
ER negative, PR positive: 25-30%
ER negative, PR negative: 10% or less

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Is there anything else I should know?

Her-2/neu testing may be done at the same time as hormone receptor status testing. A patient with a positive estrogen and/or progesterone receptor status may find their response to endocrine therapy diminished if they are also Her-2/neu-positive.

Hormone receptor status testing is not available in every laboratory. It requires experience and special training to perform and interpret. Your doctor will probably send your sample to a reference laboratory and it may take several weeks before your results are available.

It takes a small amount of cancer tissue to perform hormone receptor status testing. If a sufficient sample is not available, your doctor may make an assumption that your cancer is ER-positive and PR-positive in order to broaden your treatment options.

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Common Questions

1. Is there a blood test that can be done to check my hormone receptor status?

No. The cancer cells do not "shed" the receptors, so they are not detectable in the blood. They must be evaluated in the cancer tissue itself.

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2. Would this testing also be performed on a man?

Yes. Men do not get breast cancer as frequently as women, but it does occur and their cancer may also be ER or PR positive.

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Ask a Laboratory Scientist

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Article Sources

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NOTE: This article is based on research that utilizes the sources cited here as well as the collective experience of the Lab Tests Online Editorial Review Board. This article is periodically reviewed by the Editorial Board and may be updated as a result of the review. Any new sources cited will be added to the list and distinguished from the original sources used.

Sources Used in Current Review

(2009 April 24, Modified). General Information About Breast Cancer. National Cancer Institute [On-line information]. Available online at http://www.cancer.gov/cancertopics/pdq/treatment/breast/Patient#Keypoint4 through http://www.cancer.gov. Accessed July 2009.

(2009 May 13, Revised). Detailed Guide: Breast Cancer. American Cancer Society [On-line information]. Available online at http://www.cancer.org/docroot/CRI/CRI_2_3x.asp?rnav=cridg&dt=5 through http://www.cancer.org. Accessed July 2009.

(2009 May 13, Revised). Detailed Guide: Breast Cancer in Men, How Is Breast Cancer in Men Diagnosed? American Cancer Society [On-line information]. Available online at http://www.cancer.org/docroot/CRI/content/CRI_2_4_3X_How_is_male_breast_cancer_diagnosed_28.asp?sitearea=&level through http://www.cancer.org. Accessed July 2009.

(2008 August 5). Adjuvant therapy guide for breast cancer. MayoClinic.com [On-line information]. Available online at http://www.mayoclinic.com/print/breast-cancer-treatment/AT99999/METHOD=print&PAGE=all through http://www.mayoclinic.com. Accessed July 2009.

Swart, R. et. al. (2009 June 4, Updated). Breast Cancer [On-line information]. Available online at http://emedicine.medscape.com/article/283561-overview through http://emedicine.medscape.com. Accessed July 2009.

Sources Used in Previous Reviews

Thomas, Clayton L., Editor (1997). Taber's Cyclopedic Medical Dictionary. F.A. Davis Company, Philadelphia, PA [18th Edition].

Pagana, Kathleen D. & Pagana, Timothy J. (2001). Mosby's Diagnostic and Laboratory Test Reference 5th Edition: Mosby, Inc., Saint Louis, MO.

Hellekson, K. (2001, May 1). Practice Guidelines, NIH Statement on Adjuvant Therapy for Breast Cancer. AAFP, American Family Physician [On-line information]. Available online at http://www.aafp.org/afp/20010501/practice.html through http://www.aafp.org.

ASCO Online. Estrogen Receptors and Progesterone Receptors as Markers for Breast Cancer. American Society of Clinical Oncology [Online guidelines]. Available online at http://www.asco.org/prof/pp/html/guide/tumor/m_tumor12.htm through http://www.asco.org.

DOD (2002, April 30 last update). Department of Defense Breast Cancer Decision Guide for Military and Civilian Families [On-line information]. Available online at http://www.bcdg.org/diagnosis/prognosis.html through http://www.bcdg.org.

Hormonal Therapy, How estrogen works: Receptors in your body. Breastcancer.org [On-line information]. Available online at http://www.breastcancer.org/tre_sys_hrt_howEstWrk.html through http://www.breastcancer.org.

(2001 May). Good Response to Herceptin Found Regardless of Estrogen/Progesterone Receptor Status. Breastcancer.org [On-line information]. Available online at http://www.breastcancer.org/ren_report_2001_5.html#herceptin through http://www.breastcancer.org.

Hormonal Therapy, Hormones in breast cancer treatment. Breastcancer.org [On-line information]. Available online at http://www.breastcancer.org/tre_sys_hrt_role.html through http://www.breastcancer.org.

NCI (1999 October, last update). PDQ Treatment Summary for Health Professionals: Breast Cancer. The National Cancer Institute of The National Institutes of Health [On-line information]. Available online at http://my.webmd.com/content/article/1680.50695 through http://my.webmd.com.

ACS (2001). Hormone Therapy. American Cancer Society [On-line information]. Available online through http://www.cancer.org.

ACS (2001). How is Breast Cancer Diagnosed? American Cancer Society, Cancer Reference Information [On-line information]. Available online through http://www.cancer.org.