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Clin Breast Cancer. 2018 Feb;18(1):1-8. doi: 10.1016/j.clbc.2017.06.005. Epub 2017 Jun 23.

Borderline ER-Positive Primary Breast Cancer Gains No Significant Survival Benefit From Endocrine Therapy: A Systematic Review and Meta-Analysis.

Author information

1
Department of Breast Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, People's Republic of China.
2
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT.
3
Department of Pathology, Qilu Hospital, Shandong University, Jinan, Shandong Province, People's Republic of China.
4
Department of Radiation Oncology, Rutgers Cancer Institute of New Jersey, Rutgers, The State University of New Jersey, New Brunswick, NJ.
5
Department of Breast Surgery, Qilu Hospital, Shandong University, Jinan, Shandong Province, People's Republic of China; Pathology Tissue Bank, Qilu Hospital, Shandong University, Jinan, Shandong Province, People's Republic of China. Electronic address: qifengy_sdu@163.com.

Abstract

Endocrine responsiveness of primary breast cancers with borderline estrogen receptor expression (ER+ [1%-9%]) remains unclear. We aimed at investigating differences in endocrine responsiveness, prognosis, and clinicopathological characteristics between the ER+ (1%-9%) cohort and the ER- cohort or ER+ (≥10%) cohort. Eligible literature published from inception to November 20, 2016 was retrieved from the PubMed database on the basis of Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data on survival outcomes were extracted and pooled odds ratios (ORs), 95% confidence intervals (CIs), and 2-tailed P values are reported. P values of the χ2 test for comparison of clinicopathological characteristics among included patients in the ER+ (1%-9%) cohort and the other 2 cohorts were calculated respectively. The analysis included 6 studies with 16,606 patients. Significant differences were detected between the ER+ (1%-9%) cohort and the other 2 cohorts on the basis of clinicopathological characteristics respectively. When taking all of the patients into analysis without consideration of treatment modality, the ER+ (1%-9%) cohort presented better prognosis than the ER- group in terms of 5-year disease-free survival (OR, 1.47; P = .046) and 5-year overall survival (OR, 1.23; P = .046). However, patients with ER+ (1%-9%) breast cancer who received endocrine therapy seemed to have a prognosis similar to those without any endocrine therapy (P = .684) and those with ER- carcinoma who received endocrine therapy (P = .145). Patients with ER+ (≥10%) tumors had better endocrine responsiveness compared with their ER+ (1%-9%) counterparts (OR, 0.52; P = .034, ER+ [1%-9%] vs. ER+ [≥10%]). Our results indicate that primary breast cancer patients with ER+ (1%-9%) expression gained no significant survival benefit from endocrine therapy, but manifested overall better prognosis than those with ER- cancer.

KEYWORDS:

Borderline estrogen receptor; Breast carcinoma; Endocrine treatment; Immunohistochemical staining; Prognosis

PMID:
28712925
DOI:
10.1016/j.clbc.2017.06.005
[Indexed for MEDLINE]

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