Estrogen and progesterone hormone receptor (ER and PR) status tests are standard tests for all invasive breast cancers, and on recurring cancers, as recommended by guidelines published in 2010 by the American Society of Clinical Oncology (ASCO) and the College of American Pathologists (CAP). Hormone receptor status is used to predict an individual's cancer outcome (as a prognostic marker) and to determine if hormone therapy will be an effective treatment.
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, such as the anti-hormone treatment tamoxifen.
Hormone receptor status testing is recommended as part of an initial workup when a person has been diagnosed with invasive breast cancer. Typically, testing is also performed on breast cancer that has returned after successful treatment (recurred). Patients with non-invasive breast cancer (ductal carcinoma in situ, DCIS) may discuss the option with their health practitioners and decide to undergo testing as part of their workup.
In general, if a person's cancer is ER-positive and PR-positive, the individual will have a better than average prognosis, and their cancer is likely to respond to endocrine therapy such as tamoxifen. 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 is not likely to benefit from endocrine therapy.
An individual's response to endocrine therapy will depend on a variety of factors, but typical response rates include:
HER2/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 HER2/neu-positive.
Hormone receptor status testing is not available in every laboratory. It requires experience and special training to perform and interpret. A health practitioner will probably send a patient's sample to a reference laboratory and it may take several days to weeks before the results are available.
It takes a small amount of cancer tissue to perform hormone receptor status testing. If a sufficient sample is not available, a health practitioner may make an assumption that a patient's cancer is ER-positive and PR-positive in order to broaden the treatment options.
This article was last reviewed on December 13, 2013. | This article was last modified on March 10, 2014.
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